ESOC 2022 | Lacunar stroke: acute treatment and secondary prevention

Francesco Arba, MD, PhD, FESO, Careggi University Hospital, Florence, Italy, discusses the latest approaches to lacunar stroke acute management and secondary prevention. Intravenous thrombolysis is well established as an effective treatment strategy for patients with lacunar stroke. Alteplase is given as the standard of care for patients with acute ischemic stroke, including lacunar stroke, presenting within 4.5 hours of symptom onset. The data is less clear regarding optimal secondary prevention strategies. Single antiplatelet therapy is the mainstay of treatment for secondary prevention. There is a lack of evidence regarding the safety and efficacy of short term dual antiplatelet therapy for lacunar stroke specifically, yet it is known that longer term dual antiplatelet treatment confers significant risk of major bleeding and symptomatic intracranial hemorrhage, without further benefit. This interview took place at the ESOC 2022 congress in Lyon, France.