The global market share for antithrombotic drugs is 53.1% of all the drugs for cardiovascular disease (CVD). Furthermore, these micro-channels can be designed to attain shear stresses ranging from low venous to high arterial, resembling in vivo conditions within the same device for examining the role of platelet adhesion during thrombosis. With the progressions in protein adhesion techniques in microfluidic devices, the biomimetic micro-channels can be internally coated with appropriate biological substrates, such as von Willebrand factor (VWF), collagen, Tissue Factor (TF) or fibrinogen. Micro-fabrication technology has created new horizons for novel designs in microfluidic devices that can imitate diverse physiologically relevant structures required for the investigation of multi-factorial causes of thrombosis. The dynamic shear rate driving the blood flow in a complex vascular network of varied dimensions is a crucial factor responsible for both venous and arterial thrombosis. Arterial thrombosis results in the formation of platelet-rich clots in the presence of a high shear rate, whereas venous thrombosis is the result of fibrin-rich clots occurring at low shear rates. Thrombus (clot) formation is the result of an interaction of platelets at the site of injury and the meshwork around the platelets formed by fibrin (fibre-like protein) deposition. Thrombosis is the leading cause of morbidity and mortality, responsible for approximately one in four deaths worldwide, based on the statistics derived from the Global Burden of Diseases study from 1990–2010.
The screening of compounds can be achieved with cost-effective miniaturisation technology, which not only reduces the consumption of reagents but also efficiently manages parallel sample-processing in a shorter period compared to alternative conventional methods. With an increase in the number of compounds and molecular targets available, major pharmaceutical and biotechnology companies are using HTS technologies such as robotics, lab automation, optimised detectors, etc. HTS is now a well-established technology used primarily in drug discovery. Among the major advantages of microfluidic and LOC technology in the field of biology and biochemistry is its application to high-throughput screening (HTS). The miniaturised nature of these LOC devices typically results in the design and manufacture of fluidic networks with sub millimetre characteristic dimensions. Lab on a chip (LOC) technology, largely enabled through microfluidics, is a multidisciplinary subject dedicated to the development of laboratory experiments carried out in a miniaturised format. The particular physical laws governing fluids at this level have led to new areas of research with many diverse applications. Broadly, microfluidics refers to the handling and manipulation of, typically sub millilitre, volumes of fluids. Complex vascular networks and blood flow parameters can be modelled using microfluidics to aid the understanding of the pathophysiology of blood disorders. It is expected that, by 2030, the treatment cost for blood coagulation related disorders will rise to approximately USD 800 billion. A haemostatic imbalance can lead to either excessive bleeding or undesired clotting conditions. Haemostasis is a complex wound healing process, activated by nearly eighty biochemical reactions that arrest blood at the site of injury while maintaining normal blood flow elsewhere in a vascular system. Innovative design specifications, fabrication techniques, and modes of detection in addition to the materials used in developing micro-channels are reviewed in the context of application to the field of haemostasis. In this review, both advanced microfluidic devices (R&D) and commercially available devices for the diagnosis and monitoring of haemostasis-related disorders and antithrombotic therapies, respectively, are discussed. Microfluidic technologies present innovative solutions to diagnostic and clinical challenges which have the knock-on effect of improving health care and quality of life. The field of microfluidic and Lab on a Chip (LOC) technologies is rapidly advancing and the important role of miniaturised diagnostics is becoming more evident in the healthcare system, with particular importance in near patient testing (NPT) and point of care (POC) settings. As leading causes of mortality worldwide, there is an ever-increasing drive to improve the diagnosis and prevention of haemostatic disorders.
Haemostatic disorders are both complex and costly in relation to both their treatment and subsequent management.
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