In an effort to improve results and provide salvage for thrombolytic failure, clinical investigators in stroke have begun evaluating strategies of combination therapy, including mechanical and pharmacological augmentation of thrombolysis. Recent studies have sparked optimism for combining IV alteplase [t-PA] with transcranial Doppler (TCD) ultrasound, with catheter-based intervention or with intra-arterial thrombolytic therapy. Results of the combination strategies were reported at the American Stroke Association 25th International Stroke Conference [New Orleans, US; February 2000].