Journal Article

Vessel wall magnetic resonance imaging findings and surgical treatment in nilotinib-associated cerebrovascular disease: A case report

Nakano, Yoshiteru, Saito, Takeshi, Kakeda, Shingo, Nishizawa, Shigeru, Suzuki, Kohei, Yamamoto, Junkoh, Takamatsu, Seishiro, Miyaoka, Ryo, Kitagawa, Takehiro

2019

Overview

Nilotinib, a second-generation tyrosine kinase inhibitor, is considered as one of the most effective drugs for the treatment of chronic myeloid leukemia (CML); however, the use of nilotinib has been reported to be associated with vascular adverse events, such as peripheral arterial occlusive disease and ischemic heart disease. Moreover, there are few reports on cerebral vascular disease associated with nilotinib use. We herein describe the case of a 55-year-old male patient with CML, who presented with cerebral infarction and severe cerebrovascular stenosis that developed during nilotinib treatment. The patient was diagnosed with cerebral infarction and severe stenosis of the intracranial arteries associated with nilotinib use. Vessel wall magnetic resonance imaging (VW-MRI) revealed diffuse concentric thickening of the vessel wall, unlike ordinary patterns of atherosclerosis. The patient underwent direct revascularization (superficial temporal artery to middle cerebral artery bypass) and was successfully treated without recurrence. Based on this rare case, VW-MRI may be used to detect the morphological changes of the intracranial arteries that are associated with nilotinib use. Moreover, surgical revascularization may improve the prognosis of nilotinib-associated cerebrovascular diseases, such as severe stenosis or occlusion of the main trunk of the cerebral arteries, that cause brain ischemia.

• Publisher: D.A. Spandidos,Spandidos Publications,Spandidos Publications UK Ltd
• Subject: Antineoplastic agents / Arteries / Atherosclerosis / Cancer treatment / Cardiovascular diseases / Care and treatment / Carotid arteries / Case reports / Case studies / CAT scans / Cerebral ischemia / cerebral vascular disease / Cerebrovascular disorders / cerebrovascular stenosis / Cholesterol / Chronic myeloid leukemia / Complications and side effects / Development and progression / Diabetes / Drug therapy / Heart diseases / Hypertension / Inhibitor drugs / Ischemia / Low density lipoproteins / Magnetic resonance imaging / Medical imaging / Middle age / Myeloid leukemia / Myocardial ischemia / Nilotinib / NMR / Nuclear magnetic resonance / Oncology / Patients / Phenols (Class of compounds) / Platelet-derived growth factor / Stenosis / Surgery / surgical revascularization / Targeted cancer therapy / Tomography / Tyrosine / Vascular diseases / Veins & arteries / vessel wall magnetic resonance imaging