Factor v leiden mutation in reocclusion after intra-arterial thrombolysis.

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.