on October 16, 2008
Published online before print October 16, 2008, doi: 10.1161/STROKEAHA.108.522771
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Submitted on April 9, 2008
From the WSU/DMC Comprehensive Stroke Program, Department of Neurology (A.K., G.M.N., A.R.X., S.C.) and the Department of Neurosurgery (S.M., A.R.X.), Wayne State University School of Medicine, Detroit, Mich, USA. * To whom correspondence should be addressed. E-mail: akuruvilla{at}doctor4u.com.
Background and Purpose—Reocclusion of intracranial arteries after successful recanalization is associated with poor clinical outcome. The role of Factor V Leiden mutation in intracranial arterial thrombosis/rethrombosis is unclear. Summary of Report—We report the case of a patient who developed recurrent reocclusions of the middle cerebral artery after intra-arterial thrombolysis for acute ischemic stroke. The patient subsequently underwent transcatheter clot retrieval followed by successful stent-supported angioplasty of the occluded segment. He underwent a detailed workup for thrombophilia. The patient was detected to be heterozygous for Factor V Leiden mutation without any other cause for thrombophilia. Conclusions—Factor V Leiden mutation could be a contributing etiology for reocclusion after endovascular interventions in stroke. Systematic studies looking for thrombophilic mutations in patients with arterial reocclusion might be warranted.
Revised on May 23, 2008
Accepted on May 27, 2008
Factor V Leiden Mutation in Reocclusion After Intra-Arterial Thrombolysis
Abraham Kuruvilla MD*;
Key words: acute stroke • Factor V Leiden • reocclusions • rtPA • thrombolysis