The use of microfluidics in hemostasis: clinical diagnostics and biomimetic models of vascular injury.

PURPOSE OF REVIEW: This article reviews the application of microfluidic technologies in hemostasis. The emphasis is on promising developments in devices for clinical applications and novel approaches to modeling complex hemodynamics. RECENT
FINDINGS: Microfluidics combined with micropatterning of prothrombotic substrates provides devices for measuring platelet function and coagulation with low blood volumes (∼100 μl) over a wide range of shear stresses. This technology has been applied to the diagnosis of bleeding and thrombotic disorders, as well as to dosing and monitoring of anticoagulation and antiplatelet agents. Microfluidic devices that mimic vascular geometries such as bifurcations, stenosis, and complex interconnected networks yield complex flow fields that have revealed new mechanisms of platelet adhesion and aggregation. Applying techniques from tissue engineering by endothelializing these networks is beginning to close the gap between in-vitro and in-vivo models of vascular injury.
SUMMARY: Microfluidic technology enables researchers to create in-vitro models of vascular disease with unprecedented control of the biochemical and biophysical conditions. Two promising directions are flow-dependent clinical assays and biomimetic vascular networks. These approaches are particularly well suited for modeling the microvasculature. However, caution should be used when extrapolating results from microfluidic channels to the pathophysiology of thrombosis in large arteries and veins.