Popliteal artery entrapment associated with cannabis arteritis.
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.


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.


CONCLUSIONS
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.
Ducasse
E
E
Unit of Vascular Surgery, Catholic Institute of Lille, Lille, France.
Chevalier
J
J
Dasnoy
D
D
Speziale
F
F
Fiorani
P
P
Puppinck
P
P
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000209:etiology*; D001167:Arteritis / Q000150:complications*; D003251:Constriction, Pathologic; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications*; D011150:Popliteal Artery / Q000473:pathology