Blood Coagulation and Blood–Material Interactions

The blood coagulation system plays the critical role of maintaining hemostasis in the body by generating thrombus (i.e., a blood clot) to stop the loss of blood when a blood vessel is broken. However, the natural behavior of blood is also to initiate a thrombotic response when it comes in contact with a synthetic material surface. This response is thus problematic when synthetic materials are used in medical devices to treat cardiovascular and vascular problems, which can lead to the failure of the device, blockage of blood flow, or the generation of emboli leading to stroke or organ failure. This chapter addresses these topics by first providing an overview of the blood coagulation system and its connection with the complement and inflammatory systems of the body. An overview of the interactions of blood when it comes in contact with synthetic material surfaces is then provided. This topic is then followed by an overview of the approaches that have been taken in attempts to improve the blood compatibility of medical devices that are used in blood-contacting applications.