Using blood-contacting catheters, infections, thromboses, and stenoses are among the most frequent complications. They are caused by surface properties of the basic material. Ion beam based processes such as ion implantation (silicone rubber) and ion beam assisted deposition (silver-based coatings) affect only the outer micron of the treated material surface; there is little effect on bulk properties. These processes were employed also in the production of large-bore catheters used for extra-corporeal detoxification. In a prospective study in 56 patients, 72 large-bore catheters were inserted into the internal jugular and subclavian veins and investigated after removal for bacterial colonization using a scanning electron microscope. In 24 patients 30 surface-treated catheters (Spi-Argent I n = 14; Spi-Silicone n = 16) were used. 42 untreated catheters used in 32 patients served as controls. Bacterial colonization was observed in 8.9% in contrast to 38.1% in untreated catheters. The scanning electron microscopic investigations showed in all catheters a low thrombogenicity. The ion beam based processes make the surface-treated catheters thrombus and infection resistant.