Abstract

Background: The rise of e-cigarette use in the United States has been rapid, yet its impact on peripheral artery disease (PAD) remains largely unexplored. This study investigates the relationship between e-cigarette use and PAD using a mouse ischemic hindlimb model. Method: Mice aged 6-8 weeks were divided into four groups. Three groups inhaled e-cigarette vapor continuously for 14, 20, or 28 days prior, and for 28 days after hindlimb ischemia (HLI) surgery, using an InExpose system (Figure 1). A control group was exposed to room air (RA) before and after HLI. Laser-Doppler perfusion imaging tracked hindlimb blood flow, and functional deficits were assessed using the modified ischemia scale. Figure 1: Methodology Results: Blood perfusion in the ischemic hindlimb of the e-cigarette groups (EC-14, EC-20, EC-28) was significantly lower than the non-vaping group at 21 days post-surgery. In the EC-14 group, perfusion improved after 10 days of vaping cessation (Figure 2). Additionally, there was a reduction in platelet and leukocyte counts in the e-cigarette groups compared to RA, with no difference in red blood cells. Necrosis and claw damage were observed in EC-20 and EC-28 groups but not in non-vaping mice. Figure 2: Representative images of perfusion recovery measured by LDPI. Conclusion: Chronic e-cigarette nicotine exposure impairs blood flow recovery and causes necrosis in mice with hind limb ischemia, potentially due to perturbed angiogenesis and arteriogenesis. This study highlights the detrimental effects of e-cigarette nicotine on vascular health.

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