Clotting and thrombosis remain one of the most serious problems in the development of blood contacting devices.Strategies for developing antithrombotic surfaces are generally based on the idea of preventing clot formation.However

they have so far met with only limited success since coagulation appears to be inevitable when a foreign surface is in contact with blood.Alternatively

by designing the surface effectively to mimic the fibrinolytic system in the vasculature

it may be possible for clots to be lysed as they form.Over the past two decades

work on the fibrinolytic surface concept has established its validity.In this review we elaborate this concept and discuss ways in which such a surface could be realized.Developments in this area to the present time are reviewed

and some perspectives for future research are presented.We hope that this review may serve to stimulate additional research on this neglected but promising and potentially important approach to blood compatibility.