Prosthetic graft seeding: breathing new life into old grafts.

A major constraint in vascular surgery is the failure of the currently available prosthetic grafts to match the patency of autogenous vein below the inguinal ligament. Endothelial seeding aims to produce an endothelial lining which is otherwise absent from prosthetics. This could improve patency by preventing thrombosis and the release of mitogens by activated platelets implicated in the development of neointimal hyperplasia. Experimental evidence supports the potential of the technique but clinical trials have been less conclusive. A number of problems need to be solved if this application of cell biology is to become a part of vascular surgical practice.