Stroke is the leading cause of life-threatening neurologic disease and the third leading cause of death in the United States, with an incidence of 500,000 cases per year. In the past there was no effective treatment. Recently intra-arterial thrombolysis has emerged as a promising treatment for strokes. At University Hospitals of Cleveland, in a trial of intra-arterial urokinase, 85% of patients showed angiographic evidence of recanalization and 61% showed excellent or good neurologic improvement. A 15% complication rate and 15% death rate was noted however. Further studies will be needed to prove whether this is an effective treatment.