Figure 1: Causes and contributors to atherosclerosis, restenosis, and vein graft disease. Surgical treatment in arteries blocked by atherosclerotic plaque may result in restenosis or vein graft disease, caused by endothelial cell (EC) loss or dysfunction, neointimal formation (smooth muscle cell (SMC) proliferation and extracellular matrix synthesis), inflammation, thrombus incorporation into the vessel wall, and vascular remodelling (recoil, medial, and/or adventitial growth).