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Although an internal mammary artery graft is immune to restenosis, a saphenous vein graft is prone to develop restenosis. We found significantly higher activity of phosphatase and tensin homolog (PTEN) in the smooth muscle cells of the internal mammary artery than in the saphenous vein. In this article, we critically review the pathophysiology of vein-graft failure with detailed discussion of the involvement of various factors, including PTEN, matrix metalloproteinases, and tissue inhibitor of metalloproteinases, in uncontrolled proliferation and migration of smooth muscle cells towards the lumen, and invasion of the graft conduit. We identified potential target sites that could be useful in preventing and (or) reversing unwanted consequences following coronary artery bypass graft using saphenous vein. <\/jats:p>","DOI":"10.1139\/cjpp-2013-0445","type":"journal-article","created":{"date-parts":[[2014,5,16]],"date-time":"2014-05-16T17:44:13Z","timestamp":1400262253000},"page":"531-545","source":"Crossref","is-referenced-by-count":32,"title":["Coronary artery bypass graft: why is the saphenous vein prone to intimal hyperplasia?"],"prefix":"10.1139","volume":"92","author":[{"given":"Swastika","family":"Sur","sequence":"first","affiliation":[{"name":"Department of Biomedical Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Surgery, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devendra K.","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA."},{"name":"Center for Clinical and Translational Science, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"155","reference":[{"key":"refg1\/ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70050-9"},{"issue":"5","key":"refg2\/ref2","first-page":"886","volume":"96","author":"Adcock O.T.","year":"1984","journal-title":"Surgery"},{"key":"refg3\/ref3","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90429-5"},{"key":"refg4\/ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(96)01045-4"},{"key":"refg5\/ref5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.1.515"},{"issue":"3","key":"refg6\/ref6","first-page":"241","volume":"3","author":"Alrawi S.J.","year":"2000","journal-title":"Heart Surg. 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