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In a small saucepan, melt the butter over low-medium heat. Add cream and stir. Add salt and optional extract. Cool slightly.
Place chopped white chocolate in a heatproof bowl over a double boiler. Stir until smooth.
Gently fold lukewarm cream mixture into melted chocolate until fully blended.
Stir in chopped cranberries and pistachios evenly.
Cover with plastic wrap directly on surface. Let sit at room temp 1 hour, then chill 2–3 hours until firm.
Scoop and roll mixture into 1-inch balls. Clean hands between rolls.
Roll each truffle in powdered sugar until fully coated.
Keep truffles in airtight container refrigerated for up to 1 week or freeze if needed.