Cannabis May Be an Overlooked Risk Factor for Leg Artery Disease | Research

The takeaway

Emerging evidence links cannabis use to peripheral arterial disease through vasospasm, endothelial damage, and platelet changes, particularly in younger patients.

Vascular surgeons, emergency physicians, primary care doctors seeing young patients with limb ischemia

What the researchers found

Several mechanisms link cannabis to vascular risk: cannabinoid-induced vasospasm, endothelial dysfunction, platelet aggregation, and oxidative stress. Epidemiological studies show associations between cannabis use disorder and increased PAD complications, particularly acute limb ischemia and chronic limb-threatening ischemia.

Why it matters

As cannabis legalization expands, clinicians may see more young patients with unexplained leg artery problems. Recognizing cannabis as a potential vascular risk factor could lead to earlier diagnosis and better outcomes.

The numbers in context

Review covers epidemiological trends linking cannabis use disorder to acute limb ischemia (ALI) and chronic limb-threatening ischemia (CLTI). Limited perioperative data suggests potential adverse surgical outcomes.

How the study worked

Narrative review incorporating epidemiological data, clinical studies, and mechanistic investigations, with emphasis on pathophysiological processes relevant to arterial compromise and their association with cannabis use disorder.

What this study cannot tell us

Narrative review without systematic methodology. Most evidence is from case reports and small series. Concurrent tobacco and other substance use confounds associations. Causal mechanisms remain unproven.

How to read the evidence

Narrative review synthesizing limited evidence from case reports, small studies, and mechanistic research. Causal relationship not established.

When this study was published

Published 2026, responding to recent Australian cannabis legalization.

The bigger picture

Cannabis-associated arteriopathy has been described for decades but remains poorly recognized. With legalization expanding in Australia and globally, the vascular surgery community needs to become more aware of this potential risk factor — especially in patients too young for typical PAD.

Questions still open

What cannabis consumption patterns create the highest vascular risk? Is there a dose-response relationship? Could specific cannabinoids (THC vs. CBD) have different vascular effects? Should vascular screening be recommended for heavy cannabis users?

Common questions

Can cannabis cause leg artery problems?

Emerging evidence suggests cannabis may contribute to peripheral arterial disease through blood vessel spasm, damage to vessel linings, and changes in blood clotting — particularly concerning for younger users who wouldn't typically develop these conditions.

Should doctors ask about cannabis use when diagnosing artery problems?

Yes — this review argues that with legalization expanding, clinicians should consider cannabis as a potential vascular risk factor, especially in younger patients presenting with unexplained limb ischemia.

Read the original research

The Impact of Cannabis Use on the Prevalence, Progression and Development of Lower Limb Peripheral Arterial Disease: A Narrative Review.

ANZ journal of surgery

View on PubMed ↗Publisher’s paper ↗

Citation

Lee, Frances; Zhang, Daniel; Patel, Kiraati; Lee, Arvind. (2026). The Impact of Cannabis Use on the Prevalence, Progression and Development of Lower Limb Peripheral Arterial Disease: A Narrative Review.. ANZ journal of surgery. https://doi.org/10.1111/ans.70528