Vein grafts: haemodynamic forces on the endothelium--a review

To review the mechanisms believed to be important in the development of vein graft stenosis, with particular attention placed on the adaptation of saphenous vein endothelium to a new haemodynamic environment.

Discussion based on review of published research.

The aetiology of vein graft stenosis remains to be established and appears to be multi-factorial. The increasing evidence for an important role of haemodynamic forces is discussed, particularly via the interaction of these force with the endothelium.

Further understanding of the interaction between haemodynamic forces, blood constituents and the newly implanted vein graft is required. Use of in vitro models is contributing increasing knowledge to this area, but ultimately better non-invasive methods of assessing haemodynamic forces in vivo are required.