Acute ischemic stroke is both ubiquitous and undertreated. Only a small fraction of patients currently receive clot-busting drugs or mechanical thrombectomy because of the small treatment window. That’s because existing therapies require rapid presentation to specialized centers and carry nonreversible bleeding risks that make clinicians hesitant to use them. Basking Biosciences is developing a first-in-class, reversible thrombolytic that targets von Willebrand factor to expand access to safe, effective treatment. Basking Biosciences CEO Julia Owens and co-founder and chief scientific officer Shahid Nimjee discuss the tension between restoring blood flow and causing irreversible intracranial hemorrhage that clinicians face in treating ischemic stroke, the narrow treatment window for existing therapies, and how modulating von Willebrand factor may open a much larger treatment window across a broader range of care settings.