Mimicking the fibrinolytic system on material surfaces

Clotting and thrombosis remain the most serious problems in the development of blood contacting devices such as heart valves, vascular stents, grafts and catheters. No material exists that does not provoke these phenomena and coagulation appears to be inevitable when a foreign (i.e. non-endothelial) surface is in contact with blood. As an alternative to a surface that prevents coagulation, the concept of a clot-lysing or fibrinolytic surface is attractive. By designing the surface effectively to mimic the fibrinolytic system in the vasculature, it may be possible for clots to be lysed (effectively dissolved) as they form. In this review we elaborate on 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.