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Updated: Aug 18, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 27, 2013
Intraarterial thrombolytic therapy in acute stroke
1Department of Neurology, RWTH Aachen, FR Germany.
Intraarterial thrombolytic therapy by means of urokinase has proved to be effective and safe in certain instances of acute thromboembolic occlusion of the vertebral and/or the basilar artery. Small hemorrhages have not led to deterioration in the patients' neurological state. In the territory of the carotid artery local thrombolytic therapy may be effective in very selected cases of acute thromboembolic occlusion. There is a high risk of intracerebral hemorrhage. Possibly intravenous administration of tPA will replace local intraarterial thrombolysis, provided a strict regimen is established for selection of patients, determination of dosage and time constraints for the application of this therapy.
Intraarterial thrombolytic therapy by means of urokinase has proved to be effective and safe in certain instances of acute thromboembolic occlusion of the vertebral and/or the basilar artery. Small hemorrhages have not led to deterioration in the patients' neurological state. In the territory of the carotid artery local thrombolytic therapy may be effective in very selected cases of acute thromboembolic occlusion. There is a high risk of intracerebral hemorrhage. Possibly intravenous administration of tPA will replace local intraarterial thrombolysis, provided a strict regimen is established for selection of patients, determination of dosage and time constraints for the application of this therapy.
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