Engineering anti-thrombogenic and anti-infective catheters through a stepwise metal-catechol-(amine) surface engineering strategy

Thrombosis and infection are pivotal clinical complications associated with interventional blood-contacting devices, leading to significant morbidity and mortality. To address these issues, we present a stepwise metal-catechol-(amine) (MCA) surface engineering strategy that efficiently integrates therapeutic nitric oxide (NO) gas and antibacterial peptide (ABP) onto catheters, ensuring balanced anti-thrombotic and anti-infective properties. First, copper ions were controllably incorporated with norepinephrine and hexanediamine through a one-step molecular/ion co-assembly process, creating a NO-generating and amine-rich MCA surface coating. Subsequently, azide-polyethylene glycol 4-N-hydroxysuccinimidyl and dibenzylcyclooctyne modified ABP were sequentially immobilized on the surface via amide coupling and bioorthogonal click chemistry, ensuring the dense grafting of ABP while maintaining the catalytic efficacy for NO. This efficient integration of ABP and NO-generating ability on the catheter surface provides potent antibacterial properties and ability to resist adhesion and activation of platelets, thus synergistically preventing infection and thrombosis. We anticipate that this synergistic modification strategy will offer an effective solution for advancing surface engineering and enhancing the clinical performance of biomedical devices. • Biomimetic surface engineering strategy: Integrate NO and ABP onto material surfaces. • A simple molecular/ion self-assembly process: Create an NO-generating and MCA network. • Efficiency and specificity of click chemistry: Graft ABP onto material surfaces. • Superior in vitro and in vivo anti-thrombotic and anti-infective performance. • Long-term stability: The modified material maintains functions for at least one month.