For 30 years polyester textile materials in tubular form have been used in vascular surgery for the replacement and by-pass of arteries. Initially such medical devices were implanted to maintain the distal blood flow of atherosclerotic patients for a number of months. Today, with prognoses in excess of 10 or 15 years, and with implantation in younger and younger patients, this particular end use is possibly one of the most demanding applications for a textile product. The paper describes the current manufacturing techniques and provides detailed information about the wide variety of filaments, yarns and fabrics used in the production of current commercial devices. By reviewing the mechanical and clinical performance of available designs against the criteria of an 'ideal' prosthesis, the objective of this paper is to assist surgeons in making clinical decisions, to provide the textile and medical products industries with directions for future design improvements, and to support standards writers in their formidable task of establishing a rational standard for vascular repair devices.