Hemocompatibility is a critical consideration when designing cardiovascular devices. Methods of assessing hemocompatibility range from in vitro protein adsorption and static platelet attachment to in vivo implantation. A standard preclinical assessment of biomaterial hemocompatibility is ex vivo quantification of thrombosis in a chronic arteriovenous shunt. This technique utilizes flowing blood and quantifies platelet accumulation and fibrin deposition. However, the physical parameters of the thrombus have remained unknown. This study presents the development of a novel method to quantify the 3D physical properties of the thrombus on different biomaterials: expanded polytetrafluoroethylene and a preclinical hydrogel, poly(vinyl alcohol). Tubes of 4–5 mm inner diameter were exposed to non-anticoagulated blood flow for 1 hour and fixed. Due to differences in biomaterial water absorption properties, unique methods, requiring either the thrombus or the lumen to be radiopaque, were developed to quantify average thrombus volume within a graft. The samples were imaged using X-ray microcomputed tomography (microCT). The methodologies were strongly and significantly correlated to caliper-measured graft dimensions (R2 = 0.994, p < 0.0001). The physical characteristics of the thrombi were well correlated to platelet and fibrin deposition. MicroCT scanning and advanced image analyses were successfully applied to quantitatively measure 3D physical parameters of thrombi on cardiovascular biomaterials under flow.

33-year-old female, with learning difficulties and idiopathic epilepsy, (treated with phenytoin and lamotrigine), was admitted with a 24-hour history of drowsiness and urinary frequency. Five days earlier the family doctor had prescribed amoxycillin to treat breathlessness. On examination, the patient was drowsy but responsive (Glasgow Coma Scale) [GCS] 13/15), pulse 140/min, ECG: sinus tachycardia, BP 130/80 mmHg, temperature 35.9°C, respiratory rate 30/min with O 2 saturation of 95%. Cardiovascular, respiratory, abdominal and neurological systems were otherwise normal. Diabetic ketoacidosis (DKA) was confirmed (plasma glucose 28 mmol/L, bicarbonate 7 mmol/L, pH 6.98, P CO 2 2.2, sodium