Local intraarterial fibrinolytic therapy (LIF) in patients with acute vertebrobasilar occlusion (AVBO) is a rational and if successful a life saving treatment. The recent progress in this field is determined by the use of microcatheters for superselective basilar artery catheterisation and a "short time, highdose" regimen using 750.000 IU Urokinase in not more than two h. Two out of 7 patients died and 1 did not improve to a better than a locked-in-state. Four patients however survived with excellent outcome.