Staged carotid artery stenting for nilotinib-induced cervical internal carotid artery stenosis: illustrative case.

Background: 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.

Observations: 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.

Lessons: 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.