Thrombogenicity of biomaterials depends on hemodynamic shear rate

Han, Qing; Shea, Susan M.; Arleo, Timothy; Qian, Joshua Y.; Ku, David N.

doi:10.1111/aor.14093

Cited by 10 publications

(10 citation statements)

References 35 publications

(69 reference statements)

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“…The exposure of patient blood to foreign materials whose walls are covered with adsorbed proteins, providing sites for thrombotic interactions. Many studies have brought significant contributions to the biomaterials-driven thrombosis fields, with regard to innovative coatings for instance, material composition or surface modification (Han et al, 2022;Jamiolkowski et al, 2022). .…”

Section: Discussionmentioning

confidence: 99%

Design of artificial vascular devices: Hemodynamic evaluation of shear-induced thrombogenicity

Feaugas

Newman²,

Calzuola³

et al. 2023

Front. Mech. Eng.

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Blood-circulating devices such as oxygenators have offered life-saving opportunities for advanced cardiovascular and pulmonary failures. However, such systems are limited in the mimicking of the native vascular environment (architecture, mechanical forces, operating flow rates and scaffold compositions). Complications involving thrombosis considerably reduce their implementation time and require intensive anticoagulant treatment. Variations in the hemodynamic forces and fluid-mediated interactions between the different blood components determine the risk of thrombosis and are generally not taken sufficiently into consideration in the design of new blood-circulating devices. In this Review article, we examine the tools and investigations around hemodynamics employed in the development of artificial vascular devices, and especially with advanced microfluidics techniques. Firstly, the architecture of the human vascular system will be discussed, with regards to achieving physiological functions while maintaining antithrombotic conditions for the blood. The aim is to highlight that blood circulation in native vessels is a finely controlled balance between architecture, rheology and mechanical forces, altogether providing valuable biomimetics concepts. Later, we summarize the current numerical and experimental methodologies to assess the risk of thrombogenicity of flow patterns in blood circulating devices. We show that the leveraging of both local hemodynamic analysis and nature-inspired architectures can greatly contribute to the development of predictive models of device thrombogenicity. When integrated in the early phase of the design, such evaluation would pave the way for optimised blood circulating systems with effective thromboresistance performances, long-term implantation prospects and a reduced burden for patients.

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Section: Discussionmentioning

confidence: 99%

Design of artificial vascular devices: Hemodynamic evaluation of shear-induced thrombogenicity

Feaugas

Newman²,

Calzuola³

et al. 2023

Front. Mech. Eng.

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“…Under this assumption, when the ratio of width to height of the channel in perfusion chamber is greater than 5:1, the shear rate on the internal surface of the channel can be calculated by equation (2). 20…”

Section: Discussionmentioning

confidence: 99%

Constructing and evaluating the effect of micron-scale structures on von Willebrand factor damage

Mei,

Jiang,

Huan

et al. 2023

Int J Artif Organs

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The incidence of clinical complication gastrointestinal bleeding has been proved as consequence of von Willebrand factor (VWF) damage after mechanical circulatory support in clinic. Many studies have been conducted to evaluate VWF damage, of which the most studied influencing factors are mechanical factors such as shear stress. However, in addition to mechanical factors, VWF damage may also be affected by interface factors. To address this issue, a roller pump circulation platform was established to investigate the effect of material surface micron-scale structures distribution on VWF damage in flow state. A composite micro-structure combining microngrating and micronpost was designed and constructed on the surface of Si wafer by lithography and reactive ion etching, and detailed characterization of material surfaces was also performed. Then the changes of VWF antigen, VWF ristocetin cofactor activity, and the degradation of high molecular weight VWF on these surfaces were investigated and compared. The results showed that, with the encryption of surface micro-structures arrangement, the material surface tends to be more hydrophobic, which is beneficial to reduce VWF damage. Therefore, in the design of material surface inside the mechanical circulatory support devices, it can be considered to add some surface micro-structures with a certain distribution density to change the hydrophilicity and hydrophobicity, so as to minimize the VWF damage. These results can provide important references for the evaluation of VWF damage caused by interface factors, and aid in designing material surface inside the mechanical circulatory support devices.

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“…Three in vitro loops were perfused as described previously. 10 Porcine blood was collected from a local abattoir. Fresh whole blood harvested at the point of exsanguination was immediately added to 1 L bottles containing sodium heparin (Thermo Fisher Scientific) solution to bring the final concentration to 3.5 IU/mL.…”

Section: Connector Designmentioning

confidence: 99%

Novel tubing connectors reduce ECMO circuit thrombosis

Bresette,

Shea,

Wagoner

et al. 2024

Int J Artif Organs

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Background: Thrombosis within extracorporeal membrane oxygenation (ECMO) circuits is a common complication that dominates clinical management of patients receiving mechanical circulatory support. Prior studies have identified that over 80% of circuit thrombosis can be attributed to tubing-connector junctions. Methods: A novel connector was designed that reduces local regions of flow stagnation at the tubing-connector junction to eliminate a primary source of ECMO circuit thrombi. To compare clotting between the novel connectors and the traditional connectors, both in vitro loops and an in vivo caprine model of long-term (48 h) ECMO were used to generate tubing-connector junction clots. Results: In vitro, the traditional connectors uniformly (9/9) formed large thrombi, while novel connectors formed a small thrombus in only one of nine ( p < 0.0001). In the long-term goat ECMO circuits, the traditional connectors exhibited more thrombi ( p < 0.04), and these thrombi were more likely to protrude into the lumen of the tubing ( p < 0.001). Conclusion: Both in vitro and in vivo validation experiments successfully recreated circuit thrombosis and demonstrate that the adoption of novel connectors can reduce the burden of circuit thrombosis.

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Thrombogenicity of biomaterials depends on hemodynamic shear rate

Cited by 10 publications

References 35 publications

Design of artificial vascular devices: Hemodynamic evaluation of shear-induced thrombogenicity

Design of artificial vascular devices: Hemodynamic evaluation of shear-induced thrombogenicity

Constructing and evaluating the effect of micron-scale structures on von Willebrand factor damage

Novel tubing connectors reduce ECMO circuit thrombosis

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