Fig 2.

Vector delivery strategy to prevent vein graft disease. Prior to surgical harvesting of the vein graft, both the endothelium and underlying SMCs are in a quiescent state. Injury occurs within minutes as a result of ischemia and mechanical trauma and is exacerbated upon anastomosis into the arterial circulation. Transgene delivery is performed ex vivo and occurs rapidly and with a low risk of systemic transgene toxicity. Endothelial injury, thrombosis, inflammation, and SMC activation have been targeted for the prevention of vein graft intimal hyperplasia.