Objective comparison of multi mode under the guidance of CT vein and artery thrombolytic efficacy and safety, seeking treatment for acute cerebral infarction is safe and reliable. Methods 71 cases of acute cerebral infarction of internal carotid artery system in patients of our hospital in 2014 January to choose December -2014 accord with intraarterial thrombolysis conditions, according to the wishes of patients were divided into two groups, willing to accept the 33 cases of arterial thrombolytic therapy in patients with arterial group, unwilling to accept the 38 patients were treated with thrombolytic therapy in patients treated with intravenous thrombolysis, set to vein group, recording the period of time before and after thrombolytic therapy for patients with neurological deficit (NIHSS) score and complications, curative effect evaluation of thrombolytic therapy after 1 months. Results Patients with arterial thrombolysis group at different time after NIHSS scores were lower than the intravenous group (P＜0.05). Artery group of patients, 11 cases were basically cured, 13 cases were significantly improved, the total effective rate was 72.73%, control group, the total effective rate was 44.74% (P＜0.05). After 1 weeks of group responsibility artery thrombolysis recanalization rate was 63.64%, and then through vein group responsible vessels rate was 42.11%, (χ2 =6.3128, P＜0.05). Two groups were no significant difference (χ2 =1.2423, P＞0.05). Conclusion multi mode CT to judge acute cerebral ischemic penumbra and vascular stenosis has good guide, arterial thrombolytic drug concentration is high, can improve the recanalization rate, it also helps to improve the efficacy and quality of life.