Thrombotic vascular diseases contribute to significant global mortality, yet current therapeutic strategies face persistent challenges including bleeding risks, suboptimal efficiency, and procedural complexity. Here, we report a micro-explosive thermochemical thrombolysis (METCT) therapy via injectable liquid alkali metal (LAM) encapsulated in dimethyl silicone (LAM@oil), which enables prompt, efficient and safe vascular recanalization within an ultrafast timeframe (< 90 seconds). This LAM@oil system effectively disrupts thrombus tissue through a synergistic triple-action mechanism: Mechanical micro-explosions forces, alkaline ablation due to highly localized exothermic chemical reactions, and thermal thrombolysis mediated by elevated temperature. Upon thrombolysis completion, the non-toxic reaction byproducts (sodium and potassium ions) exhibit physiologically biocompatible and metabolizable effects. Critically, the LAM@oil demonstrates significantly higher thrombolytic efficacy compared to clinically available thrombolytic drugs (residual thrombus area percent 10.87%±7.16% for LAM@oil vs. 80.86%±13.32% for urokinase), with no associated bleeding risks. This strategy opens a byproduct-free, cost-effective, and high-efficiency alternative to conventional thrombolytics, holding big potential for clinical translation in acute thrombosis management.

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