The use of endothelial seeding of prosthetic arterial bypass grafts.

Endothelial seeding is the transplantation of vascular lining cells. On the basis of animal studies and theoretical considerations, seeding is expected to reduce acute thrombosis and stenoses because of NFH when segments of the vascular system are denuded of endothelium. Endothelialization may reduce the susceptibility of synthetic grafts to blood-borne bacterial infection. Seeding demonstrably transfers endothelium in humans. The indications for its use are limited to clinical trials in aorta-femoral and femoral-popliteal bypass operations, and the results of those trials will begin to define its indications further. In the future, endothelium may be applied to tibial and coronary synthetic arterial grafts; sites of endarterectomy, PTA, atherectomy, and laser treatments; vascular access; and venous replacement grafts.