Gene therapy for human bypass grafts

Autologous saphenous vein is the conduit of choice for the bypass of arteri al occlusive disease, be it in the peripheral arterial tree or in the coron ary system. This technique is limited by primary graft failure rates approa ching 20% in the first year for peripheral arterial disease and 50% at 10 y ears for coronary artery bypass grafting. The PREVENT trial describes a nov el, safe and effective means of ex vivo transfection of harvested vein graf ts with an E2F decoy oligonucleotide, with 70-74% decreases in the level of proliferating cell nuclear antigen (PCNA) and c-myc mRNA expressed by the smooth muscle cells in the vein. This translated into a statistically signi ficant reduction in primary graft failure when used to bypass peripheral ar terial occlusions in a high-risk human patient population.