title: On the influence of flow conditions and wettability on blood material interactions.
abstract: In this review, we hypothesise that, next to biocompatibility, optimal blood compatibility depends on a combination of biomaterials wettability and the shear stress prevailing in the device. The wettability is discussed in seven different categories of devices, that differ substantially from each other with regard to shear stress and exposure time. These seven categories are stents, prosthetic heart valves, vascular prostheses, cardiopulmonary bypass, hemodialysis, vena cava filters and blood bags. In high shear applications, in combination with blood activation, platelet deposition and thrombosis appear to be major problems and platelet inhibitors are most effective. Exposure of blood to a large biomaterial surface, with or without antithrombotic coating, results in reduction of platelet function. Material-independent activation aggravates this process. In low shear applications, platelets only seem supportive for coagulation and anticoagulants should be used.
authors.affiliation: Department of Biomedical Engineering and Cardiothoracic Surgery, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands.
authors.forename: H T
authors.initials: HT
authors.lastname: Spijker
authors.forename: R
authors.initials: R
authors.lastname: Graaff
authors.forename: P W
authors.initials: PW
authors.lastname: Boonstra
authors.forename: H J
authors.initials: HJ
authors.lastname: Busscher
authors.forename: W
authors.initials: W
authors.lastname: van Oeveren
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D001783:Blood Flow Velocity; D001793:Blood Preservation / Q000009:adverse effects; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D006354:Heart, Artificial / Q000009:adverse effects; D006801:Humans; D007688:Kidneys, Artificial / Q000009:adverse effects; D015539:Platelet Activation; D019736:Prostheses and Implants / Q000009:adverse effects*; D033081:Shear Strength; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology* / Q000503:physiopathology*; D017155:Wettability
chemical_list: D001672:Biocompatible Materials