Kushino Kakeru, Kamide Tomoya, Muranaka Takashi, Hirano Yoka, Nogami Kenshu, Takata Sho, Wajima Daisuke, Misaki Kouichi, Nakada Mitsutoshi
Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan.
J Neurosurg Case Lessons. 2025 Jun 23;9(25). doi: 10.3171/CASE25153.
Nilotinib is known to cause vascular adverse events. No case of staged carotid artery stenting (CAS) for cervical internal carotid artery (ICA) stenosis by nilotinib has been reported. This report describes a case of staged CAS for nilotinib-induced cervical ICA stenosis.
A 67-year-old man who had been receiving nilotinib for 13 years for chronic myelogenous leukemia (CML) and had undergone stent placement for arteriosclerosis obliterans 10 years after starting nilotinib treatment developed transient right hemiparesis. MRI and MR angiography showed disseminated high-intensity areas in the left hemisphere and severe stenosis of the left cervical ICA. Single-photon emission CT revealed severe steal phenomenon in the left hemisphere. Therefore, a staged CAS was performed. He made good progress to recovery and was discharged a week after the endovascular surgery.
An increasing number of patients are being treated with nilotinib because of its effectiveness in treating CML. Therefore, clinicians should recognize that patients treated with nilotinib may develop adverse vascular events, including those affecting the cervical and intracranial arteries. https://thejns.org/doi/10.3171/CASE25153.
已知尼罗替尼会引发血管不良事件。尚未有关于尼罗替尼所致颈内动脉（ICA）狭窄行分期颈动脉支架置入术（CAS）的病例报道。本报告描述了一例尼罗替尼所致颈ICA狭窄行分期CAS的病例。
一名67岁男性，因慢性粒细胞白血病（CML）接受尼罗替尼治疗13年，在开始尼罗替尼治疗10年后因动脉硬化闭塞症接受了支架置入术，出现短暂性右半身轻瘫。MRI和磁共振血管造影显示左半球有散在的高强度区域以及左颈ICA严重狭窄。单光子发射计算机断层扫描显示左半球存在严重的盗血现象。因此，进行了分期CAS。他恢复情况良好，血管内手术后一周出院。
由于尼罗替尼在治疗CML方面的有效性，接受其治疗的患者数量不断增加。因此，临床医生应认识到接受尼罗替尼治疗的患者可能会发生不良血管事件，包括影响颈和颅内动脉的事件。https://thejns.org/doi/10.3171/CASE25153
