Reactions 1680, p253 - 2 Dec 2017 Intracranial stenosis of the internal carotid artery: case report A 74-year-old woman developed intracranial stenosis of the internal carotid artery during treatment with nilotinib [dosage and route not stated]. The woman, who was diagnosed with chronic myeloid leukaemia (CML), initially received treatment with imatinib for three and a half year, which was later switched to nilotinib. During switch to nilotinib, no abnormality at the intracranial internal carotid artery (ICA) was observed. After two and a half year of nilotinib initiation, transient ischaemic attack (TIA) like transient hemiplegia was observed. Magnetic resonance angiography (MRA) revealed narrowing of basilar artery and left intracranial ICA. The woman’s nilotinib treatment was ceased and was switched to bosutinib. Bosutinib treatment was discontinued due to impairment in hepatic function of unknown cause. Dasatinib was also administered, but was stopped due to repeat episodes of right transient hemiplegia. She was started on dual antiplatelet therapy including aspirin and clopidogrel, which proved ineffective to control TIA. She was not able to sit upright due to haemodynamic impairment of the cerebral vascular circulation, which was confirmed by single photon emission computed tomography (SPECT). Subsequently, she underwent intracranial stent placement and cerebral vascular revascularisation was confirmed on SPECT. She had no further TIAs and neurological deficits, and bosutinib treatment was able to be started again. Author comment: "Herein, we report a case of a 74-year- old male CML patient with intracranial stenosis of the internal carotid artery developed during treatment with nilotinib". Ozaki T, et al. Intracranial stenting for nilotinib treatment-associated cerebrovascular stenosis in chronic myeloid leukemia. Interventional Neuroradiology 23: 527-530, No. 5, 1 Oct 2017. Available from: URL: http:// doi.org/10.1177/1591019917710810 - Japan 803284230 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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