Abstract
In literature, few cases have been reported regarding the use of alteplase installation in a nephrostomy as anticoagulant treatment of blood clots in the upper urinary tract. Our case -report provides a unique case of alteplase installation in the nephrostomy tube for thrombolysis of a blood clot formation in the upper ureter. The blood clot formation emerged as acute obstruction following a planned endoscopic lithotripsy. A new protocol for alteplase installation for percutaneous nephrostomy is presented in this article.