Lower limb occlusive arteriopathy: Retrospective analysis of 73 patients with onset before the age of 50 years.

Objectives: Juvenile peripheral obstructive arterial diseases (POAD) have been poorly investigated but account for 1 to 7% of POAD. We analyzed retrospectively a cohort of patients with onset before the age of 50 years. Patients and methods : Seventy-three patients (60 mates and 13 females) were divided into 4 groups (Buerger's disease: TAO, atheromatous PAOD. auto-immune POAD, arteriopathy of undetermined origin). Results. The first symptoms occur-red at 38 +/- 8 years of age. Fourteen patients, (201,) had TAO. 51 (70,) atheromatous POAD. 4 (5%) POAD with systemic or autoimmune disease, and 4 (5%) Undetermined POAD, Age of onset was earlier in TAO (35 +/- 8 vs 40 +/- 8 years, p = 0.046). smoking greater in the atheroma group (33 +/- 1 vs 24 +/- 14 pack-years, p = 0.033). Fifty-three POAD patients had dyslipidaemia and 26% hypertension. Regular cannabis intake was more frequent in the TAO group (2 1 vs 8%). At the time of medical care, Fontaine's stage was more frequently stage 11 in atheroma patients (57 vs 14%) and stage IV in TAO patients (86 vs 35%). TAO was diagnosed in 43% cannabis users and in 19 c non users. Conclusion : The main etiology of juvenile POAD is atheroma, followed by TAO. Cannabis users account for at least 10% of these patients, They are characterized by lower tobacco intake, more distal lesions, more frequent involvement of the upper limbs, They present more frequently as TAO.