Table 1:

Overview of the three antithrombotic design strategies.

Design Strategy	Activity classification	Examples	Common Advantages	Common Shortcomings
Immobilized anticoagulants	Bioactive (Inhibition of components of the coagulation cascade) & Passive (Can improve general biocompatibility26)	Heparin26 Thrombomdulin17, 28 Apyrase30 Hirudin31, 32 Argatroban33 rTFPI34	Localized effects33 Longevity96 Improved pharmacokinetics and pharmacodynamics compared to systemic administration26 Reduced adverse effects compared to systemic administration26 Demonstrated clinical efficacy15	Potential for reduced efficacy caused by immobilization15 Efficacy can be reduced with plasma protein adsorption37 Specific mechanism of action Does not prevent the initiation of surface-induced thrombosis
Surface property modifications	Passive (Delay of thrombosis via deterring protein adsorption)	Hydrophilicity42 Superhydrophobicity43 Zwitterions44 Surface morphology45, 46 Lubrication47	Reduced/delayed plasma protein adsorption48 Antifouling43	Plasma protein adsorption is inevitable48 Lack of inhibition of the coagulation cascade
	Bioactive (Platelet inhibition or clot disintegration)	NO generation50 Fibrinolysis52	Localized effects51 Combats large aspects of thrombosis57	Potential for reduced efficacy once covered by plasma proteins Does not prevent the initiation of surface-induced thrombosis
Release of antithrombotic compounds	Bioactive (Inhibition of components of the coagulation cascade or clot disintegration)	NO20, 58 Heparin59 t-PA62	Localized effects59 Retained efficacy compared to immobilization methods59, 96	Limited load of antithrombotic compound within material Achieving a steady and/or prolonged release