Which thrombolytic agent is commonly used within the first 3 hours of an ischemic stroke?

Alteplase is the thrombolytic agent that is commonly used within the first 3 hours of an ischemic stroke due to its effectiveness in dissolving blood clots that obstruct blood flow to the brain. It is a tissue plasminogen activator (tPA) that specifically targets fibrin, the protein that forms the mesh structure of blood clots, and converts plasminogen to plasmin, ultimately leading to clot lysis.

The timely administration of alteplase is critical in the setting of an acute ischemic stroke as it has been shown to significantly increase the chances of recovery and reduce the risk of long-term disability when given within the recommended therapeutic window. The American Heart Association and the American Stroke Association endorse the use of alteplase as the standard of care for eligible patients presenting within 3 hours of stroke symptoms.

Other thrombolytic agents listed, while effective in different settings or conditions, are either not specifically indicated for ischemic stroke or have different administration protocols that do not align with the urgent needs of stroke management. Tenecteplase and reteplase are also fibrinolytics, but their primary use is in myocardial infarction rather than stroke. Streptokinase is not routinely used for strokes due