Thrombolysis is the most effective treatment of acute ischemic stroke that increases the proportion of patients with good clinical outcome. Selective intra-arterial thrombolysis (IAT) can be used in a wider therapeutic window (up to 6-8 hours) under the angiographic control with tailoring of fibrinolytic dose. The results of IAT by a recombinant plasminogen activator in 2 patients are presented. Patient 1, male, 55 years old, with M1 cerebral middle artery (CMA) occlusion and with NIHSS score 13 on admission was treated by IAT after 7 hours of stroke onset. Recanalization was observed 40 minutes after IAT started. The NIHSS score was 8 after IAT. Patient 2, female, 64 y.o., with NIHSS score 20 on admission and C7 internal carotid artery and M1 CMA occlusion was treated by IAT. Recanalization was observed 60 minute after the beginning of IAT, with NIHSS score being decreased to 14. These clinical cases demonstrate the high efficacy of intra arterial thrombolysis in ischemic stroke patients.