Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes

Abstract

This chapter describes biomaterial―associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. The community has focused on minimizing coagulation or minimizing platelet adhesion and activation. This chapter has infrequently considered the interactions between the two although one is generally familiar with these interactions. However, one has rarely considered in the context of biomaterial-associated thrombosis the other major players in blood: complement and leukocytes. Biomaterials are known agonists of complement and leukocyte activation, but this is frequently studied only in the context of inflammation. Thrombosis is a special case of inflammation. One summarizes current perspectives on all four of these components in thrombosis and with biomaterials and cardiovascular devices. The chapter also highlights a few features of biomaterial-associated thrombosis that are not often considered in the biomaterials literature: The importance of tissue factor and the extrinsic coagulation system; complement activation as a prelude to platelet activation and its role in thrombosis; the role of leukocytes in thrombin formation; and the differing time scales of these contributions.