Key result
High-flow bypass surgery successfully treated a 39-year-old woman with nilotinib-associated cerebral arterial occlusive disease, maintaining good bypass patency without new neurological deficits at 6 months.
Why the study?
The mechanism of nilotinib-associated cerebral arterial occlusive disease has not been clarified and remains controversial.
Case Report (n=1)
No
High-flow bypass surgery was successfully used to treat nilotinib-associated cerebral arterial occlusive disease, with intraoperative findings suggesting an irreversible atherosclerotic mechanism.
Nilotinib, one of the tyrosine kinase inhibitors, has been used to treat chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Nilotinib-associated cerebral arterial occlusive disease, which is treated with medicine with/without bypass surgery or stenting, has been sporadically reported to occur. The mechanism of the nilotinib-associated cerebral disease has not been clarified and is still controversial. Here we present the case of a 39-year-old woman with Ph+ ALL treated with nilotinib, which led to symptomatic intracranial arterial stenosis. We performed high-flow bypass surgery and observed the arterial stenotic change in the stenotic portion intraoperatively, whose findings strongly supported the theory of atherosclerosis and seemed to be irreversible.
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Rai et al. (2023) conducted a case report in Tyrosine Kinase Inhibitor-associated Cerebral Arterial Occlusive Disease (n=1). High-flow bypass surgery was evaluated on Bypass patency and neurological outcomes. High-flow bypass surgery successfully treated a 39-year-old woman with nilotinib-associated cerebral arterial occlusive disease, maintaining good bypass patency without new neurological deficits at 6 months.
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