Vascular complications of injecting drug misuse

Abstract

Drug misuse is now a significant problem in western society; many different pharmaceuticals are administered by drug abusers as intravenous preparations. This has resulted in an increasing number of complications associated with prolonged intravascular and perivascular injection of abused substances. These complications of intravenous drug abuse may lead to limb-threatening arterial injuries that present a considerable management problem in patients who often have significant comorbidity. This article provides a comprehensive review of the vascular complications that result from drug misuse by injection. It discusses the aetiology and clinical features of these complications and highlights the limited role of both the general surgeon and specialist vascular surgeon in the management of these patients.

Radial artery mycotic pseudoaneurysm: An unusual complication of catheterization

“…3,5 Seventy-five percent of pseudoaneurysms are associated with a pulsatile mass. 6 Radial artery catheters have been widely used, with few complications, for hemodynamic monitoring. Their importance as a source of infection was first recognized in a patient who developed distal embolization from catheter-related bacteremia.…”

Dermatologic Signs and Symptoms of Substance Abuse

“…Acute, drug-induced thrombosis is marked by intense burning and pain immediately following intra-arterial injection of the drug. Ensuing edema develops, followed by cyanosis [4,[22][23][24]. In severe cases, skin necrosis can develop, such as scrotal necrosis due to pudendal artery thrombosis [25,26].…”

“…They are characterized by pulsatile masses in the distribution of major arteries. Non-pulsatile aneurysms may be mistaken for abscesses, which can lead to catastrophic outcomes if they are wrongfully incised [22,34,35]. Mycotic aneurysms are commonly caused by S. aureus and often involve the femoral artery due to drug injection in the groin.…”

Spritzenabszesse bei intravenös Drogenabhängigen

“…Sep ti sche Arthritiden kön nen ent we der durch hä mato ge ne Streu ung oder durch di rek te intra-/pe ri ar ti ku lä re In jek tio nen ent ste hen [13]. Zu den vas ku lä ren Kom pli ka tio nen ge hö ren die pe ri phe re Is chä mie durch intraar te ri el le In jek ti on, in fi zier te Pseu do aneu rys ma ta von Ar te ri en oder Ve nen und sep ti sche Throm bo sen [19]. Wei te re Kompli ka tio nen um fas sen Schä di gun gen lo kaler Struk tu ren, Pyo myo sitiden, sep ti schen Em bo li en durch hä ma to ge ne Streu ung und hier bei ins be son de re die Rechts herzen do kar di tis [9,8] Wir führ ten eine re tro spek ti ve Un tersu chung der Häu fig keit von Kom pli ka tionen bei Sprit zen ab szes sen in Ab hän gigkeit von der Lo ka li sa ti on des Ab szes ses und den Be gleit er kran kun gen bei i.v.…”