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CASE REPORT
Tyrosine kinase inhibitor induced rapidly progressive vasculopathy after intracranial stent placement
  1. Ching-Jen Chen1,
  2. Brian J Sorace2,
  3. Aria Shakeri2,
  4. Min S Park1,
  5. Andrew M Southerland2,
  6. Bradford B Worrall2,
  7. M Yashar S Kalani1
  1. 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, US
  2. 2Department of Neurology, University of Virginia, Charlottesville, Virginia, US
  1. Correspondence to Dr Ching-Jen Chen, Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22904, USA; cc5hx{at}hscmail.mcc.virginia.edu

Abstract

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.

  • stroke
  • stenosis
  • stent

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Footnotes

  • Republished with permission from BMJ Case Reports Published Apr 3, 2018; doi: 10.1136/bcr-2017-013548.rep

  • Contributors C-JC: conception of the project, data collection, drafting of the manuscript, critically revising the manuscript, and approval of the final manuscript. BJS and AS: drafting of the manuscript, critically revising the manuscript, and approval of the final manuscript. MSP, AMS, and BBW: critically revising the manuscript and approval of the final manuscript. MYSK conception of the project, critically revising the manuscript, and approval of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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