Cocaine-Induced Peripheral Vascular Occlusive Disease

Abstract

Two patients with cocaine-induced peripheral vascular occlusive disease are presented. A 37-year-old man was admitted to the hospital for evaluation of severe pain and numbness of his feet. He had used cocaine prior to admission. Arteriography showed bilateral occlusions of superficial femoral, popliteal, and trifucation arteries. Despite repeated infusions of urokinase, he developed progressive bilateral gangrene of both legs necessitating bilateral below-knee amputations. The second patient developed similar symptoms after smoking cocaine. Arteriography showed vasospasm bilaterally from the iliac arteries distally. IV nitroglycerin infusion caused resolution of the vasospasm and ischemic symptoms.