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Abstract
Arteries and veins respond to injury by a healing process that includes the development
of a neointima. This response to injury is implicated as the primary cause of failure
after arterial reconstruction. Because it is an integrator and transmitter of blood
flow variations, inflammation, and growth stimuli, the endothelium is a potent regulator
of long-term arterial wall mass changes. The contribution of the endothelium to intimal
development depends on the type of arterial conduit. In arteries, the growth of the
intima stops when the endothelium has regrown. In synthetic grafts, the endothelium
stabilizes intimal growth. Hence, the mere presence of endothelial cells can influence
intimal changes in arterial conduits. Understanding endothelial biology should help
us define methods to prevent cell proliferation, extracellular matrix accumulation,
intimal hyperplasia, and vessel narrowing.