Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, US.
Department of Neurology, University of Virginia, Charlottesville, Virginia, US.
J Neurointerv Surg. 2018 Nov;10(11):e28. doi: 10.1136/neurintsurg-2018-013777.rep. Epub 2018 Apr 7.
Tyrosine kinase inhibitor (TKI) therapy for chronic myeloid leukemia (CML) has been associated with progressive peripheral arterial disease and, more recently, rare cases of intracranial vascular stenosis have been reported. We report the fourth case of TKI treatment associated intracranial vasculopathy and rapid progression of intracranial vascular stenosis following intracranial stent placement. This was a 49-year-old woman who developed right-sided weakness, paresthesias, numbness, and speech difficulties 7 years following TKI treatment for CML. Cerebral catheter angiography demonstrated 90% stenosis of the left supraclinoid internal carotid artery, for which the patient underwent intracranial stent placement with no residual stenosis and improved distal blood flow. Approximately 1 month following the procedure, the patient returned with similar symptoms. Catheter angiography demonstrated 70% and 50% stenosis just distal and proximal to the stent construct, respectively. Rapid disease progression and non-atherosclerotic vasculopathy may argue against endovascular therapy.
酪氨酸激酶抑制剂（TKI）治疗慢性髓性白血病（CML）与进行性外周动脉疾病有关，最近也有报道罕见的颅内血管狭窄病例。我们报告第四例 TKI 治疗相关颅内血管病，以及颅内支架置入后颅内血管狭窄的快速进展。这是一名 49 岁女性，在 CML 的 TKI 治疗 7 年后出现右侧无力、感觉异常、麻木和言语困难。脑血管造影显示左侧颈内动脉颅外段 90%狭窄，患者接受颅内支架置入术，无残余狭窄，远端血流改善。术后约 1 个月，患者出现类似症状。导管血管造影显示支架结构远端和近端分别有 70%和 50%狭窄。疾病快速进展和非动脉粥样硬化性血管病可能不支持血管内治疗。
