Ponatinib is a third-generation Tyrosine Kinase Inhibitor (TKI), approved as first-line treatment for Chronic Myeloid Leukaemia (CML) chronic phase.

Here we describe a CML patient with a history of subsequent TIAs and an ischemic stroke during Ponatinib treatment. Patient was admitted for a 3-day history of sudden onset left hemiparesis due to an acute ischemic stroke. MRI showed bilaterally the almost total absence of signal in the intracranial tract of anterior circulation and low signal of cerebral posterior circulation. Digital Subtraction Angiography showed multiple steno-occlusions of both anterior and posterior circulation large vessels.

The association between cerebrovascular events and TKIs of second and third-generation has been widely described. So Ponatinib was stopped. To our knowledge, this is the first case of multiple ischemic strokes and recurrent TIAs during treatment with Ponatinib, pointing out the importance of accurate quantification of cardiovascular risk before starting Ponatinib.

Ponatinib是第三代酪氨酸激酶抑制剂（TKI），已被批准作为慢性粒细胞白血病（CML）慢性期的一线治疗药物。

在这里，我们描述了一名CML患者，该患者在Ponatinib治疗期间有随后的TIA病史和缺血性中风。患者因急性缺血性中风突然发作左偏瘫3天。MRI显示双侧前循环颅内几乎完全没有信号，而脑后循环则几乎没有信号。数字减影血管造影显示前循环和后循环大血管有多个狭窄闭塞。

脑血管事件与第二代和第三代TKI之间的关联已被广泛描述。因此，Ponatinib被停用。据我们所知，这是在使用Ponatinib治疗期间出现多发性缺血性卒中和TIA反复发作的首例病例，指出在开始Ponatinib之前准确量化心血管风险的重要性。