A 45-year-old with no traditional risk factors developed recurrent peripheral artery disease linked to 20 years of daily marijuana use | Research

The takeaway

A 45-year-old man required three vascular surgeries for peripheral artery disease despite having no diabetes, hypertension, or high cholesterol, with his only identifiable risk factors being 20 years of daily marijuana and alcohol use.

Vascular surgeons, cardiologists, primary care providers evaluating unexplained PAD

Three vascular surgeries by age 45 with no traditional risk factors beyond chronic marijuana and alcohol use

What the researchers found

Recurrent severe PAD requiring multiple bypass surgeries in a patient without traditional cardiovascular risk factors; daily marijuana and alcohol use for 20 years were the only identifiable risk factors; arterial Doppler showed severe occlusion in multiple leg arteries.

Why it matters

This case illustrates that chronic cannabis use may be an underrecognized risk factor for peripheral artery disease, particularly in younger patients without classic cardiovascular risk factors.

The numbers in context

45-year-old male; 20 years daily marijuana and alcohol use; 3 vascular surgeries (2017 bypass, 2018 revision, current bypass); severe occlusion of superficial femoral, popliteal, and dorsalis pedis arteries.

How the study worked

Case report of a 45-year-old male presenting with left leg pain and severe atherosclerotic disease requiring femoral-tibial bypass; history of two prior vascular surgeries; 20 years of daily marijuana and alcohol use.

What this study cannot tell us

Single case report; concurrent alcohol use makes it impossible to attribute findings to marijuana alone; no control comparison; case reports cannot establish causation.

How to read the evidence

Single case report provides a clinical illustration but cannot establish causation, particularly given concurrent alcohol use.

When this study was published

Published 2025

The bigger picture

Marijuana's vascular effects (endothelial dysfunction, inflammation) are increasingly recognized, and clinicians should consider chronic cannabis use when evaluating unexplained early-onset peripheral vascular disease.

Questions still open

What proportion of early-onset PAD may be attributable to cannabis use? Is the mechanism primarily endothelial dysfunction or arterial inflammation? Would cessation prevent disease progression?

Common questions

Can marijuana cause artery disease?

This case cannot prove causation, but the patient developed severe peripheral artery disease at a young age with no traditional risk factors beyond 20 years of daily marijuana and alcohol use, suggesting chronic cannabis may contribute.

What happened to the patient?

He required three vascular surgeries over several years for recurrent arterial blockages in his legs, including two femoral bypass procedures and a graft revision.

Read the original research

Recurrent Peripheral Artery Disease in a 45-Year-Old Male Without Hypercoagulable Comorbidities.

Cureus, 17(7), e89057

View on PubMed ↗Publisher’s paper ↗

Citation

Cohen, Adi; Cohen, Jessica; Cordeiro de Oliveira, Igor; Anasseri, Sheela; Ahmed, Faryal; Cherner, Rebecca. (2025). Recurrent Peripheral Artery Disease in a 45-Year-Old Male Without Hypercoagulable Comorbidities.. Cureus, 17(7), e89057. https://doi.org/10.7759/cureus.89057