Recurrent Peripheral Artery Disease in a 45-Year-Old Male Without Hypercoagulable Comorbidities

Area of Science:

• Vascular Medicine
• Cardiovascular Research
• Substance Abuse Research

Background:

• Peripheral artery disease (PAD) is a common vascular condition often linked to traditional risk factors like diabetes, hypertension, and hyperlipidemia.
• Emerging research suggests non-traditional factors, including marijuana and alcohol use, may contribute to endothelial dysfunction and vascular inflammation, key elements in PAD pathogenesis.

Observation:

• A 45-year-old male with a history of PAD and previous bypass surgeries presented with severe left lower leg pain.
• His social history revealed 20 years of daily marijuana and alcohol use.
• Imaging confirmed severe atherosclerotic disease and occlusion in the superficial femoral, popliteal, and dorsalis pedis arteries of the left leg.

Findings:

• The patient underwent a left femoral-tibial arterial bypass due to extensive arterial occlusion.
• This case suggests a potential association between chronic polysubstance abuse (marijuana and alcohol) and the development of PAD in the absence of typical comorbidities.
• Vascular effects of chronic substance use, though documented, are often overlooked in clinical practice.

Implications:

• Highlights the importance of considering non-traditional risk factors, such as chronic substance use, in the diagnosis of peripheral artery disease.
• Emphasizes the need for increased physician awareness regarding the vascular impact of marijuana and alcohol.
• Suggests that recognizing these non-traditional risk factors can lead to earlier diagnosis and improved management of PAD, potentially enhancing patient outcomes.