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Cannabis Arteritis: About 8 cases
Sayarh Salma*, Lekehal Brahim, Fellat Rokya and Fellat Nadia
Vascular surgery and cardiology departments of Ibn Sina Hospital, University Mohamed V, Morocco
Received Date: 23/03/2023; Published Date: 16/06/2023
*Corresponding author: Sayarh Salma, Department of Vascular Surgery, Ibn Sina Rabat University Hospital, Mohamed V University of Rabat, Morocco
Purpose of Work
To report eight cases of arteritis directly related to the consumption of cannabis, and to highlight the difficulties of taking charge of this type of arteriopathy as severe as it is early. We will discuss the etiopathogenic links that exist between Buerger's disease and cannabis arteritis.
Introduction
The responsibility of cannabis in the occurrence of juvenile thrombangiitis is a hot topic. Arterial involvement resembles Leo Buerger's disease in its clinical and radiological representation, it differs in the need for excessive and regular consumption of cannabis, as well as in its anatomopathological aspect.
Materials and Methods
This is a retrospective study of eight cases of arteritis, followed in our training and directly related to the consumption of cannabis. Patients accumulating major cardiovascular risk factors and patients aged over 40 were excluded.
Results
These are eight patients, all male, heavy cannabis users (5 to 6 joints per day), with no major associated cardiovascular risk factors and hospitalized for treatment of painful trophic disorders of the limbs. There were three cases with upper extremity localization. Doppler ultrasound and arteriography showed distal lesions resembling those seen in Buerger's disease.
Figure 1: Angiographic appearance of leg arteries (a) and of the foot (b) in a young cannabis user.
Figure 2: Trophic disorder of the foot in this same patient.
Treatment consisted of stopping cannabis intoxication associated with antiplatelet agents and vasodilators. Lumbar sympathectomy was performed in three patients by laparoscopy. The evolution was favorable in five patients with a healing of their trophic disorders and a clear improvement in terms of pain. Two patients had a forefoot amputation within three months of diagnosis, and another a transfemoral amputation 5 months later.
Conclusion
Cannabis is by far the most commonly used illicit psychoactive substance among young people aged 15-25 in our context. Data from the literature show that it is responsible for a type of arterial disease similar to those found in Buerger's disease. The prognosis of this arteriopathy is rather pejorative, on the one hand, they are often distal attacks without possibility of revascularization, and on the other hand they are often maintained because of the difficulties of weaning of these patients.
