Abstract

Blood-contacting medical devices, such as vascular stents, intravascular catheters, and artificial heart valves, frequently encounter complications in clinical practice, including thrombosis, inflammatory reactions, and infections. These challenges pose significant obstacles in the effective application of blood-contacting medical devices. Given that protein adhesion serves as the primary trigger for detrimental events upon contact with blood, this review focuses on various anti-fouling coating strategies aimed at inhibiting protein adsorption. Currently, surface modification of blood-contacting medical devices primarily involves the construction of active or passive anti-fouling coatings. This review explores the implementation of active and passive anti-fouling coating strategies utilizing chemistry, physics, and biotechnology. Examples of anti-fouling coatings discussed include hydrophilic polymer coatings, zwitterionic polymer coatings, superhydrophobic coatings, and composite coatings. Furthermore, we propose implementation approaches for these coatings to address inflammation and infection challenges associated with blood-contacting devices. The review concludes with a brief overview of current surface modification technologies employed in commercial anti-fouling coatings and offers insights into the future of anti-fouling coating technologies for blood-contacting material surfaces. These advancements are essential for the advancement of design, development, and application of blood-contacting materials.

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