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Thrombosis may result in ECMO circuit changes, cause red blood cell hemolysis, and thromboembolic events. Medical device thrombosis is potentiated by the interplay between biomaterial properties, hemodynamic flow conditions and patient pathology, however, the contribution and importance of these factors are poorly understood because many in vitro models lack the capability to customize material and flow conditions to investigate thrombosis under clinically relevant medical device conditions. Therefore, an ECMO thrombosis\u2010on\u2010a\u2010chip model is developed that enables highly customizable biomaterial and flow combinations to evaluate ECMO thrombosis in real\u2010time with low blood volume. It is observed that low flow rates, decelerating conditions, and flow stasis significantly increased platelet adhesion, correlating with clinical thrombus formation. For the first time, it is found that tubing material, polyvinyl chloride, caused increased platelet P\u2010selectin activation compared to connector material, polycarbonate. This ECMO thrombosis\u2010on\u2010a\u2010chip model can be used to guide ECMO operation, inform medical device design, investigate embolism, occlusion and platelet activation mechanisms, and develop anti\u2010thrombotic biomaterials to ultimately reduce medical device thrombosis, anti\u2010thrombotic drug use and therefore bleeding complications, leading to safer blood\u2010contacting medical devices.<\/jats:p>","DOI":"10.1002\/advs.202401524","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T05:13:47Z","timestamp":1715922827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Platelet Adhesion and Activation in an ECMO Thrombosis\u2010on\u2010a\u2010Chip Model"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-9528","authenticated-orcid":false,"given":"Tiffany","family":"Goh","sequence":"first","affiliation":[{"name":"School of Medical 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