A Review of the Histologic Changes in Vein-to-Artery Grafts, With Particular Reference to Intimal Hyperplasia

This article reviews the success of vein-to-artery grafts and the published data on patency rates and the major causes for graft failure, ie, intimal hyperplasia and atherosclerosis. It concentrates on the histogenesis of intimal hyperplasia and describes the histologic changes that occur in a vein graft after its insertion. The origin and behavior of intimal smooth-muscle cells are discussed in detail, with particular reference to their role in intimal hyperplasia. A brief experimental section is included to show the specific identification of vein-graft intimal smooth-muscle cells using light-microscopic histochemistry and electron microscopy.