Thrombosis continues to be a primary cause of acute occlusion of vein grafts. Transposing a vein to the arterial milieu exposes the constituent endothelial and smooth muscle cells to altered biomechanical forces. The increased, pulsatile pressure (P) and flow (Q) and resultant pulsatile wall distension lead to increased and fluctuating shear stres and cyclic stretch. when used as a coronary artery bypass graft, the vein segment is subjected to additional cyclic strains, including twisting and stretching caused by the rhythmic contraction of the heart.~(1,2)
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