Cardiovascular disease is the leading global killer, and durable small-diameter vascular grafts (≤6 mm) remain unmet needs. Synthetic grafts fail due to thrombosis and intimal hyperplasia, while biologics lack scalability. This project develops decellularized vascular grafts from thrombospondin-2 knockout (TSP2-KO) pigs, combining native strength with a pro-regenerative matrix. TSP2 deletion enhances cell infiltration and reduces thrombogenicity. Building on NHLBI SBIR Phase I success and rat patency data, we will test grafts in a sheep model, then scale production and complete regulatory preparation, delivering a biocompatible, manufacturable graft platform for CABG, PAD, and AV access.