Chapter 17 Intimal hyperplasia and graft failure
Abstract Over the last four decades, improvements in surgical technique and vascular grafts have permitted the reconstruction of both large and small vessels. Although such reconstructions may be technically satisfactory, they may fail for several reasons: spontaneous thrombosis, restenosis, or infection. This chapter focuses on the problem of restenosis as it applies to vascular grafts and other forms of arterial reconstruction. Over the last five years, substantial progress has been made in defining the various factors contributing to stenosis. Perhaps the most important is intimal smooth muscle hyperplasia. During the next decade, a detailed understanding of molecular mechanisms that regulate smooth muscle function should permit the development of pharmacological strategies to prevent restenosis (1).