The present disclosure relates to methods and systems for removing a vascular obstruction in a subject using a combination ofthrombolytic and laser ablation therapy. Treatment methods include positioning a catheter adjacent to an obstruction within a vessel of a subject. A portion of the obstruction may be ablated by delivering laser energy through the optical fibers to the distal end of the catheter, where the optical fibers are exposed, and circulating a fluid containing one or more thrombolytic agents to a remaining portion of the obstruction for a predetermined amount time. Fluid containing one or more thrombolytic agents capable of dissolving a remaining portion of the obstruction may be circulated through the fluid delivery lumen and removed through the fluid removal lumen.
