TY - JOUR T1 - Aortic dissection after ramucirumab infusion JF - European Journal of Hospital Pharmacy JO - Eur J Hosp Pharm SP - 117 LP - 120 DO - 10.1136/ejhpharm-2019-001879 VL - 27 IS - 2 AU - Davide Zenoni AU - Flavio Niccolò Beretta AU - Vanessa Martinelli AU - Alessandro Iaculli AU - Maria Teresa Benzoni Fratelli AU - Delia Bonzi Y1 - 2020/03/01 UR - http://ejhp.bmj.com/content/27/2/117.abstract N2 - A female patient in her seventies affected by a signet-ring cell carcinoma G3pT4N3 (24/29), with lymphovascular invasion, HER2-negative. After completing three cycles of first-line systemic treatment in combination with cisplatin (CDDP) + 5-fluorouracil (5FU), a new systemic therapy line with paclitaxel + Cyramza (ramucirumab) was planned. On the day after the first administration the patient manifested a Standford type A aortic dissection (AD), with a diameter of around 6.5 cm and dissection flap originating in the ascending aorta below the brachiocephalic trunk, extended to the whole descending aorta until the carrefour.The causal relationship between adverse drug reactions and Cyramza, calculated using the Naranjo algorithm, led to a result of 'probable' correlation between ramucirumab and AD. The endothelial dysfunction associated with vascular endothelial growth factor pathway inhibitors (VPIs) would seem to be the most plausible explanation for such events: it causes thromboembolic events and cardiovascular complications. ER -