Tetrahydrocannabinol vape-associated cannabis arteritis in a patient with minimal tobacco exposure

Thromboangiitis obliterans (TAO) is an inflammatory vasculopathy that often presents in young men with substantial tobacco use. Cannabis arteritis is the cannabis-associated counterpart, but there remains controversy over its classification due to overwhelming concurrent tobacco use. A 31-year-old man developed lifestyle-limiting claudication that coincided with vaping high-potency tetrahydrocannabinol. Notably, his tobacco exposure was limited to a remote history of <1 pack-year. His claudication considerably improved after 4 weeks of cannabis cessation. This case demonstrates a rare instance of cannabis arteritis without concurrent tobacco use, suggesting cannabis may act as an independent causative agent of a distinct thromboangiitis obliterans-like arteritis.