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Peer-reviewedCC BYJournal of surgical case reports

Diffuse stimulant-associated vasculopathy presenting with acute limb ischemia, compartment syndrome, and multifocal visceral infarction.

  • Syed Azaan Adnan1
  • Julianne Wanner1
  • Syed Moaiz Adnan2
  • Christopher Thompson3
  1. 1Campbell University School of Osteopathic Medicine, Leon Levine Hall of Medical Sciences, 4350 US Hwy 421 S, Lillington, NC 27546, United States.
  2. 2Brock University, Department of Health Sciences, 1812 Sir Isaac Brock Way, St. Catharines L2S 3A1, Canada.
  3. 3WakeMed Health and Hospitals, Department of Addiction Medicine, 3000 New Bern Ave, Raleigh, NC 27610, United States.
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Abstract

Stimulant-induced vasculopathy typically presents as localized ischemia secondary to vasospasm and thrombosis. Diffuse involvement of multiple vascular territories is uncommon and may result in severe, multisystem complications and increased morbidity. We report a 40-year-old female with polysubstance exposure, including cocaine and amphetamines, who presented with acute right lower extremity ischemia and compartment syndrome. Computed tomographic angiography demonstrated distal tibial, peroneal, and posterior tibial arterial occlusion. The patient underwent emergent four-compartment fasciotomy, allowing Doppler signals to return. Postoperative complications included rhabdomyolysis, acute kidney injury, bilateral adrenal infarctions, left renal infarction, and persistent foot drop. This case highlights the need to consider stimulant-associated vasculopathy in patients with acute limb ischemia without an embolic source and to evaluate for concurrent renal and visceral ischemic injuries. Early recognition and multidisciplinary management are essential to reduce morbidity.

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Cite

BibTeXRIS
BibTeX
@article{adnan2026diffuse,
  title = {{Diffuse stimulant-associated vasculopathy presenting with acute limb ischemia, compartment syndrome, and multifocal visceral infarction.}},
  author = {Syed Azaan Adnan and Julianne Wanner and Syed Moaiz Adnan and Christopher Thompson},
  journal = {Journal of surgical case reports},
  year = {2026},
  month = oct,
  doi = {10.1093/jscr/rjag930},
  url = {https://europepmc.org/article/MED/42899273},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Diffuse stimulant-associated vasculopathy presenting with acute limb ischemia, compartment syndrome, and multifocal visceral infarction.
AU  - Syed Azaan Adnan
AU  - Julianne Wanner
AU  - Syed Moaiz Adnan
AU  - Christopher Thompson
PY  - 2026
DA  - 2026/10/19
JO  - Journal of surgical case reports
DO  - 10.1093/jscr/rjag930
UR  - https://europepmc.org/article/MED/42899273
AB  - Stimulant-induced vasculopathy typically presents as localized ischemia secondary to vasospasm and thrombosis. Diffuse involvement of multiple vascular territories is uncommon and may result in severe, multisystem complications and increased morbidity. We report a 40-year-old female with polysubstance exposure, including cocaine and amphetamines, who presented with acute right lower extremity ischemia and compartment syndrome. Computed tomographic angiography demonstrated distal tibial, peroneal, and posterior tibial arterial occlusion. The patient underwent emergent four-compartment fasciotomy, allowing Doppler signals to return. Postoperative complications included rhabdomyolysis, acute kidney injury, bilateral adrenal infarctions, left renal infarction, and persistent foot drop. This case highlights the need to consider stimulant-associated vasculopathy in patients with acute limb ischemia without an embolic source and to evaluate for concurrent renal and visceral ischemic injuries. Early recognition and multidisciplinary management are essential to reduce morbidity.
SN  - 2042-8812
ER  -