Cisplatin-Associated Occlusion of the Internal Carotid Artery

Abstract

Background: Cisplatin is a highly effective antineoplastic agent used also in germ cell cancer. Thromboembolic complications like pulmonary embolism, myocardial infarction and stroke have occasionally been reported. Case Report: A 46-year-old man with seminoma and without any cerebrovascular risk factors developed an acute stroke with complete right-sided hemiparesis and global aphasia, during the second cycle of cisplatinbased chemotherapy. After exclusion of an intracerebral bleeding, a systemic thrombolysis was performed. Further diagnostics revealed an acute occlusion of the left carotid internal artery with infarction in the territory of the middle cerebral artery. The patient slowly recovered; however, a moderate aphasia and partial hemiparesis persisted whereas the tumor was in complete remission. Months later, the patient developed symptomatic epilepsy. Conclusions: Ischemic stroke associated with cisplatinbased chemotherapy is rare, but may be disabling or even fatal. With regard to the literature, several precautions are discussed to minimize the risk of these major side effects.

Accident Vasculaire Cerebral Ischemique Post-Chimiotherapie Pour Cancer De La Langue Ischemic Stroke Induced by Chemotherapy for Tongue Cancer

“…Studies in the literature show that the risk of ischemic stroke in chemotherapy does not appear to be related to the type of cancer but to the type of drug used [3,4]. Thus, in the cases reported the most incriminated drugs were cisplatin [5][6][7][8] which comes in 1st position and 5-Fluorouracil (5FU). Both were used in our patient.…”

Cancer-related Stroke due to Mural Thrombus in the Extracranial Carotid Artery

“…Since a CRS in patients without the conventional stroke etiology is characterized by the elevation of D-dimer levels and the presence of microembolic signals detected by transcranial Doppler, its etiological mechanism is mainly regarded as an embolism caused by hypercoagulopathy (1,4,5). In contrast, cases of a CRS that produces a thrombus in a large vessel have rarely been reported, and in most of them, cisplatin-based chemotherapy was administered (2,(6)(7)(8)(9)(10). Thrombus formation is assumed to be due to vascular toxicity associated with cisplatin, including induced endothelial damage and increased platelet aggregation (11), as well as hypercoagulopathy due to cancer itself.…”

“…In contrast, cases of CRS due to a large vessel thrombus have only rarely been reported. In most of them, cisplatin-based chemotherapy as well as cancer itself contributed to the thrombus formation (2,(6)(7)(8)(9)(10). We herein report a patient presenting with ischemic stroke due to a thrombus of the extracranial carotid artery complicating metastatic colorectal adenocarcinoma.…”

Effects of cisplatin on the contractile function of thoracic aorta of Sprague-Dawley rats

“…It has been reported that there is a high incidence of cardiovascular events in survivors of cisplatin-based chemotherapy cancer patients (25), either in acute or long-term chemotherapy (26,27). Cisplatin was reported to lead to aortic occlusion in some cases and this impairment was usually irreversible (28,29). In one case, a 36-year-old man who was treated with bleomycin-etoposide-cisplatin therapy for testicular cancer received chronic coronary artery dissection (30).…”