Veins are the most commonly used conduit to surgically bypass arterial stenoses. Veins are structurally distinct from arteries, and are forced to adapt to the arterial environment when used as arterial bypass grafts. Unfortunately, this remodeling can be pathologic and a high proportion of vein bypass grafts will fail, leading to ischemia or additional procedures. We are specifically studying the effect of extracellular nucleotide signalling in vein graft maladaptation. Using state-of-the-art mechanical stretch models that mimic vein graft function and mouse models of vein graft disease, our investigative efforts have focused on venous adaptations to arterial environments.