GENETIC MANIPULATION OF VEIN GRAFTS

A greater understanding of the molecular and genetic bases of cardiova scular diseases has made the design of therapeutic genetic interventio ns feasible in these clinical entities. Bypass vein graft failure repr esents a serious limitation in the long-term treatment of occlusive di sease in the coronary and peripheral circulations, and traditional pha rmacotherapeutic approaches have not significantly affected the course of vein graft disease. Direct access to vein graft tissue at the time of operation may provide a practical means of manipulating graft func tion at the genetic level, and an intraoperative genetic engineering s trategy has, in fact, been developed that inhibits the neointimal hype rplasia and accelerated atherosclerosis that are at the root of most g raft failures. The molecular basis for this approach is explored, as i s the potential for other genetic vein graft manipulations.