Antithrombotic coatings are categorized into active and passive types. Active anti-thrombotics, such as Heparin and Hirudin, either chemically bond to or release from the coating.

Heparin prevents thrombin formation, reducing platelet activation and thrombus formation, while Hirudin is a low-molecular-weight agent that is stable, effective in small doses, and does not cause bleeding.

Hydromer is one of the established service providers available on the market that can offer anti-thrombogenic medical device coatings.

Brief introduction

Advancements in biomaterial composition and coatings have enhanced outcomes for medical devices related to thrombosis, but clot formation remains a major concern.

Thrombi can cause device failure, necessitate reintervention, and lead to severe complications if they dislodge.

Blood-contacting devices range from short-term uses like guide wires to long-term implants such as stents and LVADs. Effective anti-thrombotic strategies vary with device type and usage, impacting thrombosis rates.

Background

Coil embolization with a stent is particularly effective and widely used. However, this method can lead to thrombus formation due to blood-stent incompatibility, increasing the risk of vascular occlusion.

Antiplatelet therapies are usually needed by patients to reduce this risk, but they can also increase the risk of bleeding and thrombotic problems.

Moreover, the long-term use of these treatments burdensà the patient and increases medical expenses.

Many anti-thrombogenic polymer coatings have been created to address problems with stent-induced thrombus development.

These coatings work well to stop thrombus formation, but they also make it more difficult for endothelialization—the process by which endothelial cells cover the stent—to occur. For a stent to heal, complete endothelialization is essential.

However, if cell adhesion is impaired, the healing process is slowed down, which increases the risk of bleeding problems and prolongs the requirement for antiplatelet medication.

As a result, coating technologies that combine improved cell adherence and anti-thrombotic qualities to encourage reendothelializations have become clinically necessary.

However, achieving both properties simultaneously has been challenging, and no such coating materials have been successfully developed.

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Protein adsorption

In the past, thrombus formation mechanisms have been connected to protein adsorption onto device surfaces.

Fibrinogen and other pro-thrombogenic proteins have the ability to stick to the device, promoting platelet adhesion and activation and the subsequent production of fibrin clots.

Without initial protein adherence, the device surface might remain inert, allowing blood to flow naturally without forming clots.

Surface modifications to reduce thrombogenicity

First-generation biomaterials for blood-contacting implantable devices primarily included naturally inert materials like silicones and poly tetrafluoroethylene (PTFE).

These materials are still widely used as coatings for coronary guide wires due to their low surface energy and friction properties.

Additionally, hydrophilic coatings have been popular for guide wires and catheters to resist protein adsorption and facilitate smoother movement through arteries.

Summary

In order to create biomaterial surfaces on blood-contacting medical devices that are resistant to thrombus formation, a variety of technological platforms have been investigated.

These approaches include physical or chemical treatments, incorporation of anti-thrombotic drugs, and biofunctionalization to mimic endothelial properties or promote re-endothelializations.

While clinical testing has demonstrated varying degrees of efficacy for these technologies, device-related thrombosis remains a persistent challenge.

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