Popliteal Artery Entrapment Associated with Cannabis Arteritis

• Published in: European journal of vascular and endovascular surgery Vol. 27; no. 3; pp. 327 - 332
• Main Authors: Ducasse, E, Chevalier, J, Dasnoy, D, Speziale, F, Fiorani, P, Puppinck, P
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2004
• Subjects: Adult; Arterial Occlusive Diseases - etiology; Arteritis; Arteritis - complications; Cannabis arteritis; Constriction, Pathologic; Humans; Male; Marijuana Abuse - complications; Popliteal Artery - pathology; Popliteal artery entrapment; Popliteal entrapment syndrome; Popliteal entrapment syndrome; Popliteal artery entrapment; Cannabis arteritis; Arteritis
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/S1533-3167(03)00100-6

Objective. To report popliteal artery entrapment in a patient with distal necrosis and cannabis-related arteritis, two rare or exceptional disorders never described in association. To conduct a targeted review and especially to seek information on the clinical presentation with characteristics specific to each disorder so as to hasten the diagnosis and choose appropriate management.
Material and methods. A 19-year-old man who presented with plantar claudication associated with necrosis in a toe underwent diagnostic arteriography and surgery for popliteal artery entrapment type III.
Results. Surgical clearance resolved the popliteal artery entrapment but left the clinical symptoms unchanged. Closer questioning disclosed a history of cannabis consumption and intravenous vasodilatory therapy was started. After the 21-day course of vasodilator agents the pain disappeared and the toe necrosis regressed. The patient stopped taking cannabis and had no signs of recurrence.
Conclusion. Whereas a popliteal artery entrapment, albeit a rare event, is well described and responds to standardized treatment, popliteal artery entrapment associated with cannabis-induced arteritis is an exceptional event that could confuse management. Because young people—the age group mainly at risk for popliteal artery entrapment—increasingly use cannabis, cannabis arteritis could become a more frequent event associated with other arterial disorders that may confuse the diagnosis and complicate management. Our experience in a young patient suggests that coexisting popliteal artery entrapment and distal necrosis in a young patient should raise a strong suspicion of an associated vascular disorder possibly related to cannabis consumption. Intravenous vasodilatation treatment is successful provided that cannabis use is discontinued.