PLAT and arterial occlusion: The possible suggested mechanisms of action of adjunctive rtPA may be explained by a twofold effect: i) a favorable impact on endovascular procedure as suggested by the higher recanalization and higher first-pass success rates in CoT patients and, ii) an effectiveness of systemic tPA on preserving microvascular perfusion in downstream to the arterial occlusion, therefore improving benefit of large vessel recanalization 4.