The effect of cocaine on arterial perfusion of the lower limbs

Abstract

Aim – Worldwide, substance abuse is on the rise, especially amongst the young generation. Although cocaine-induced cardiovascular and cerebrovascular events are well-documented, knowledge about the relationship of cocaine use and its effect on arterial perfusion in the lower limbs is scarce. This study sought to investigate the relationship between cocaine use and peripheral arterial disease. Methods – The study population comprised of 30 subjects’ dependent on cocaine, smoking and alcohol [Group A] and another 30 subjects’ dependent on smoking and alcohol only [Group B]. A comprehensive lower limb vascular assessment was conducted utilizing pulse palpation, Doppler spectral waveform analysis, Ankle brachial pressure index and Toe brachial pressure index to determine the arterial perfusion status in the lower limbs. Results - The cocaine users’ group had lower ABPIs and TBPIs than the alcohol and smoking group only suggesting poorer vascular perfusion in lower limbs. Furthermore, a larger percentage of cocaine users had monophasic/continuous waveforms of all 3 pedal pulses compared to alcoholics/ smokers. Conversely, there was a higher percentage of alcoholic and smokers only with biphasic/ triphasic waveforms compared to cocaine users implying better vascular perfusion. Conclusion - This study exhibits that cocaine diminishes the arterial perfusion of the lower limbs suggesting that cocaine use increases the risk of peripheral arterial disease in this specific population. Regular vascular foot screening in this population is warranted if foot complications are to be avoided.