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Cocaine-induced peripheral vascular occlusive disease--a case report
A Gutierrez1, J D England, W C Krupski
1Department of Neurology, Louisiana State University School of Medicine, New Orleans 70112, USA.
Angiology
|April 2, 1998
Summary
Cocaine use can cause severe peripheral vascular occlusive disease, leading to limb amputations in some cases. However, intravenous nitroglycerin may resolve vasospasm and ischemic symptoms in affected patients.
Area of Science:
- Vascular Medicine
- Toxicology
- Cardiology
Background:
- Peripheral vascular occlusive disease (PVOD) can have various etiologies.
- Cocaine abuse is increasingly recognized as a cause of cardiovascular and peripheral vascular complications.
Observation:
- Two patients presented with severe symptoms of lower extremity ischemia following cocaine use.
- One patient developed extensive arterial occlusions and gangrene requiring bilateral below-knee amputations despite urokinase treatment.
- The second patient exhibited bilateral arterial vasospasm responsive to intravenous nitroglycerin.
Findings:
- Cocaine-induced peripheral vascular occlusive disease can manifest as severe arterial occlusion or vasospasm.
- Treatment outcomes vary, with one patient progressing to amputation and another responding to vasodilatory therapy.
- Urokinase was ineffective in preventing limb loss in the patient with arterial occlusion.
Implications:
- This highlights the critical need to consider cocaine use in patients presenting with acute limb ischemia.
- Intravenous nitroglycerin may be a viable treatment option for cocaine-induced vasospasm.
- Further research is warranted to elucidate the pathophysiology and optimize management strategies for cocaine-related vascular complications.