When would you consider intra-arterial thrombolysis for acute ischemic stroke?

The prior answer brings up several valid scenarios where IA thrombolysis may be applicable. I can offer some nuanced perspective based on current practice.

Device technology has advanced significantly since the landmark EVT trials of 2015. Today, EVT is increasingly feasible in distal-segment occlus...

Mechanical thrombectomy is considered first line over intra-arterial tPA now. I would consider IA tPA for the following scenarios:

1. The clot can’t be reached for mechanical thrombectomy, but a microcatheter can be placed for IA tPA.
2. If there is a partially occlusive clot that you don’t want to dislo...

It is wonderful how vascular neurology continues to evolve. I'm not sure there is another situation in neurology where dead brain tissue can be restored (well, at least some of it).