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(Stroke. 2009;40:660.)
© 2009 American Heart Association, Inc.

Research Letters

Factor V Leiden Mutation in Reocclusion After Intra-Arterial Thrombolysis

Abraham Kuruvilla, MD; Gregory M. Norris, MD; Sunil Manjila, MCh; Andrew R. Xavier, MD Seemant Chaturvedi, MD

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.

Correspondence to Abraham Kuruvilla, MD, Section of Stroke/Cerebrovascular Disease, Department of Neurology, 8C-UHC, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI 48201. 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.

Key Words: acute stroke • Factor V Leiden • reocclusions • rtPA • thrombolysis