Complicaciones vasculares secundarias a la administración parenteral de drogas de abuso

Summary. Introduction. Parenteral drug administration can cause a variety of arterial and venous complications which can even compromise limb viability and the patient's life. Case reports. Case 1: a 36-years-old, HIV+, HCV+, male, referred sudden pain, cyanosis, anesthesia and paralysis on the radial territory of his left hand, after arterial injection of benzodiacepine. He developed irreversible necrosis and required distal forearm amputation. Case 2: a 24-years-old, HCV+, female, suffered an acute event of active bleeding from a pulsatile mass on her left elbow, after previous arterial heroin injection. We resected the rupture pseudoaneurysm, performed extensive debridement and repaired the brachial artery with a saphenous vein patch. We isolated Staphylococcus aureus in the thrombus and we completed the surgical treatment with specific antibiotics. Case 3: a 38-years-old, HIV+, HCV+, male, referred sudden pain, cyanosis, anesthesia and paralysis on the radial territory of his left hand, after arterial injection of heroin + cocaine. We tried to limit the tissue damage with anticoagulation and intravenous iloprost but he suffered irreversible necrosis and required distal forearm amputation. Case 4: a 40-years-old, HIV+, HCV+, male, was admitted with fever and a painful swollen left lower limb, after venous injection of cocaine. We diagnosed a septic ilio-femoral deep venous thrombosis, which we treated with anticoagulation and antibiotics. Conclusions. Parenteral drug abuse can cause a wide spectrum of vascular disease, mainly in young patients, and it frequently associates infection. The therapeutic possibilities must be individualized. [ANGIOLOGÍA 2008; 60:199-204]