Commercial and Novel Drug-Loaded Coatings with Anticoagulant and/or Antibacterial Functions for Clinical Applications

Drug-loaded coatings significantly improve the bioactivities of multiple medical devices. The most widespread applications are assembling anticoagulant coatings on blood-contacting medical devices to enhance blood compatibility and applying antibacterial coatings to prevent device-induced infection. Notably, a vicious cycle between bacterial infection and thrombosis may result in deterioration of condition and even lead to treatment failure. Thrombosis caused by blood incompatibility of medical devices provides niduses for bacterial colonization, whereas bacterial endotoxins accelerate thrombosis by activating platelets. In some situations, the interactional process can also trigger inflammatory responses and calcification processes. Therefore, the demands for anticoagulant and antibacterial are necessary and mutually influenced. This review presents a summary of current commercial drug-loaded anticoagulant coatings and a detailed report on novel drug-loaded coatings with anticoagulant and/or antibacterial effects. We highlight the synthesis and assembly techniques, drug-release duration, and biofunctional behavior of referenced coatings. Based on careful comparison and comprehensive summary of the state-of-the-art literature, this review reveals the difficulties in large-scale production of the emerging coatings and the functional differences compared to the existing commercial coatings, and predicts the general process for manufacturing and commercialization.