Two types of spongy polyurethane-polydimethylsiloxane (PU-PDMS) vascular grafts (1.5 mm ID, 450 microns wall thickness) were fabricated with either a skinned (SG) or a porous (PG) luminal surface and an open mesh filamentous external surface by a spraying, phase-inversion technique. Tubular membranes, 15-20 mm in length, were all implanted by the same surgeon as infrarenal aorta replacements in male Sprague-Dawley rats weighing 250-350 g (SG: n = 12, PG: n = 23). The patency rates at 2 weeks and 3 months were 0% (0/7) and 0% (0/1) for SG, 72% (8/11) and 8% (1/12) for PG. Because the wall structure of these grafts was relatively compact and did not provide enough communicating voids, another series of 15 highly porous luminal surface grafts was fabricated with a higher void to material ratio. These grafts (HPG) exhibited a 73% patency at 3 months, with a fully endothelialized surface. The authors conclude that a very open luminal surface structure, and a high wall porosity, are significant factors of graft patency in small diameter vascular prostheses made of a porous material.