[Lower limb occlusive arteriopathy: retrospective analysis of 73 patients with onset before the age of 50 years].
OBJECTIVE
Juvenile peripheral obstructive arterial diseases (POAD) have been poorly investigated but account for 1 to 7% of POAD. We analyzed retrospectively a cohort of patients with onset before the age of 50 years.


METHODS
Seventy-three patients (60 males and 13 females) were divided into 4 groups (Buerger's disease: TAO, atheromatous PAOD, auto-immune POAD, arteriopathy of undetermined origin).


RESULTS
The first symptoms occurred at 38 +/- 8 years of age. Fourteen patients (20%) had TAO, 51 (70%) atheromatous POAD, 4 (5%) POAD with systemic or autoimmune disease, and 4 (5%) undetermined POAD. Age of onset was earlier in TAO (35 +/- 8 vs 40 +/- 8 years, p=0.046), smoking greater in the atheroma group (33 +/- 16 vs 24 +/- 14 pack-years, p=0.033). Fifty-three POAD patients had dyslipidaemia and 26% hypertension. Regular cannabis intake was more frequent in the TAO group (21 vs 8%). At the time of medical care, Fontaine's stage was more frequently stage II in atheroma patients (57 vs 14%) and stage IV in TAO patients (86 vs 35%). TAO was diagnosed in 43% cannabis users and in 19% non users.


CONCLUSIONS
The main etiology of juvenile POAD is atheroma, followed by TAO. Cannabis users account for at least 10% of these patients. They are characterized by lower tobacco intake, more distal lesions, more frequent involvement of the upper limbs. They present more frequently as TAO.
Sauvanier
M
M
Service de Médecine Interne et Pathologie Vasculaire, Hôpital Saint-André, 1, rue Jean Burguet, 33075 Bordeaux.
Constans
J
J
Skopinski
S
S
Barcat
D
D
Berard
A
A
Parrot
F
F
Guerin
V
V
Vergnes
C
C
Midy
D
D
Baste
J C
JC
Conri
C
C
D000328:Adult; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000276:immunology; D001161:Arteriosclerosis / Q000175:diagnosis*; D001327:Autoimmune Diseases / Q000175:diagnosis*; D002186:Cannabinoids / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000276:immunology; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D013919:Thromboangiitis Obliterans / Q000175:diagnosis*; D018608:Ultrasonography, Doppler
D002186:Cannabinoids