On April 27, the Ninth People’s Hospital (North Hospital)/Third People’s Hospital of Shanghai Jiaotong University School of Medicine (hereinafter referred to as the Ninth Hospital (North Hospital)) successfully performed the first case of acute cerebral infarction treated by intravenous thrombolysis combined with endovascular intervention. A 40-year-old male patient was admitted to the emergency room 2 hours later due to “sudden onset of left-sided limb weakness and slurred speech”, and was considered to have an acute cerebral infarction after an emergency cranial CT. He was immediately transferred to the Department of Neurology for treatment. After the patient’s history and examination excluded contraindications to thrombolysis, Director Wu Danhong of the Department of Neurology administered standard dose rt-PA intravenous thrombolytic therapy and quickly started the process of endovascular treatment. Director Liu Jianren of the Ninth Hospital (South Hospital) led the team to quickly carry out endovascular intervention and intracranial and extracranial cerebral angiography. Since no occlusion was found in the patient’s large intracranial arteries, embolization was not performed, and it was considered that it might be related to revascularization after early intravenous thrombolysis. If the patient failed to induce cerebral revascularization in intravenous thrombolysis, early embolization would be given if large vessel occlusion was found in the angiogram. This will be very important to improve the patient’s prognosis and reduce disability. Director Liu Jianren said that time is a crucial determinant in both intravenous thrombolysis and endovascular intervention. This patient was admitted to the hospital promptly after the onset of the disease, received rapid and effective treatment, and is now in the recovery period. In this case, a combined arteriovenous approach was used to treat the acute cerebral infarction, which is a leading treatment in China and a precedent in the Baoshan area of Shanghai. Cerebral infarction (also known as cerebral infarction, ischemic stroke, stroke) is a common and frequent disease with high mortality and disability rates. One of the most evidence-based treatments for acute cerebral infarction is intravenous thrombolytic therapy within the time window. However, the proportion of patients who can reach the hospital within the time window to perform intravenous thrombolytic therapy is less than 10%, while the recanalization rate of intravenous thrombolysis for large artery occlusion is only about 10-20%, and some patients cannot use the drugs for thrombolysis (such as being on anticoagulants, just after taking over a major surgery, drug allergy, etc.), thus affecting the treatment effect. Recent studies have shown that evidence-based evidence of the superiority of endovascular therapy combined with intravenous thrombolysis (combined arteriovenous therapy) over intravenous thrombolysis alone is mushrooming. These global multicenter clinical studies, published earlier this year in the New England Journal of Medicine, confirm the safety and efficacy of endovascular therapy for acute cerebral infarction, especially in critically ill stroke patients, and significantly reduce their mortality. Guided by such evidence, the Department of Neurology of the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (North Hospital), under the joint efforts of Director Liu Jianren and Director Wu Danhong, successfully performed the first case of intravenous thrombolysis combined with endovascular intervention in a patient with acute cerebral infarction. Science tip: Since the key to combined arteriovenous treatment of cerebral infarction is rapid, the time window for intravenous thrombolysis is generally 4.5 hours; the time window for arterial thrombolysis is 6-12 hours. Therefore, patients with cerebral infarction are suitable to be sent to hospitals nearby for treatment and should not be transported long distance. For patients in Baoshan District, if they have sudden symptoms such as crooked mouth, weak limbs and slurred speech, it is recommended to send them to the stroke center of Shanghai Ninth Hospital (North Hospital) immediately, and the stroke treatment team of Shanghai Ninth People’s Hospital will provide fast and standardized treatment.