Neo-intimal hyperplasia in vascular grafts and its implications for autologous arterial grafting

With the advent of modern microsurgical procedures and an improved understanding of the cellular dynamics of vascular graft adaptation, arterial grafts are being used more frequently in surgical practice. In this article the structure and development of neointimal hyperplasia in vascular grafts, both venous and arterial, are reviewed briefly. The underlying biology of venous graft adaptation is now well understood. However, in addition to venous grafts, many different arterial conduits are now being used; these include the radial artery, internal mammary (thoracic) and gastroepiploic arteries. The different clinical outcomes of these arterial grafts and the underlying cell biology of their adaptation to the grafted environment are also reviewed.