Impact of Cannabis Use on Outcomes after Lower Extremity Bypass

Published:September 22, 2022DOI:

      Article Highlights

      • Type of Research: Retrospective review of prospectively collected Blue Cross Blue Shield of Michigan Cardiovascular Consortium Vascular Intervention Collaborative data.
      • Key Findings: Cannabis use was associated with increased opioid use at discharge (OR: 1.56, 95% CI: 1.28-1.90). Cannabis use was associated with increased amputation at 1 year (OR: 1.25, 95% CI: 1.02-1.52) after lower extremity bypass. Additionally, cannabis use was associated with decreased bypass patency at 30 days (OR: 0.52, 95% CI: 0.36-0.78) and 1 year (OR: 0.64, 95% CI 0.47-0.86).
      • Take Home Message: Pre-operative cannabis use was associated with increased post-operative opioid use, decreased bypass graft patency, increased amputation, and increased readmission after lower extremity bypass. Patients undergoing vascular surgery should be counseled regarding the potential negative effects of cannabis use.
      • Table of Contents Summary: We conducted a retrospective review of a large statewide collaborative database and found that pre-operative cannabis use was associated with increased post-operative opioid use, decreased bypass graft patency, and increased amputation after lower extremity bypass. Pre-operative cannabis is associated with negative post-operative outcomes after lower extremity bypass.



      Cannabis is one of the most commonly used substances in the United States, with national use on the rise. However, there is a paucity of data regarding the effects of cannabis and surgical outcomes. The aim of this study was to assess the association of cannabis use on post-operative outcomes after lower extremity bypass.


      We queried a large statewide registry from 2014 to 2021 to assess patients who underwent lower extremity bypass procedures. Data were gathered regarding cannabis use and the association with post-operative outcomes at 30 days and 1 year.


      11,013 patients were identified. 91.0% (10,024) reported no cannabis use while 9.0% (989) reported cannabis use in the past month. As compared with non-cannabis users, patients using cannabis had higher opioid use at discharge (OR: 1.56, 95% CI: 1.28-1.90), decreased bypass patency at 30 days (OR: 0.52, 95% CI: 0.36-0.78) and 1 year (OR: 0.64, 95% CI 0.47-0.86) and an increased amputation rate at 1 year (OR: 1.25, 95% CI: 1.02-1.52) after lower extremity bypass.


      This study shows that cannabis use in vascular surgical patients was associated with decreased graft patency, increased amputation, and increased opioid use after lower extremity bypass procedures. Although future studies are needed, the present study provides novel data that can be used to counsel patients undergoing vascular surgery.
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