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Acute treatment strategies in posterior circulation stroke

Francesco Arba, MD, PhD, FESO, Careggi University Hospital, Florence, Italy, discusses acute treatment strategies in posterior circulation stroke. Infarctions occurring within the posterior circulation arteries represent approximately 20% of all ischemic strokes and can be highly variable in presentation, depending on the location of the occlusion. Basilar artery occlusion is one of the most severe subtypes, associated with a high risk of disability and mortality. New data presented in May 2022 has provided the first evidence of the efficacy of endovascular therapy in selected patients with basilar artery occlusion, up to 12 hours after symptom onset. As a whole, the acute stroke treatment paradigm is evolving to consider tissue windows more heavily than time windows. Advanced imaging can accurately assess ischemic stroke evolution and identify late-presenting patients with the presence of a penumbra who may benefit from reperfusion therapy. This interview took place at the ESOC 2022 congress in Lyon, France.