{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:52:21Z","timestamp":1777672341642,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine High Impact Case Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Anabolic-androgenic steroid (AAS) use is prevalent among noncompetitive bodybuilders, with potential severe vascular complications. While thrombotic events have been reported with AAS use, bilateral acute limb ischemia (ALI) requiring amputation is rare. We present a case of bilateral limb ischemia, in a young adult who use AAS. Our patient is a 40-year-old male, a bodybuilder with a 4-year history of cyclic AAS use, who presented with bilateral leg pain and burning sensations from the knees to the feet. CT angiography revealed multiple embolic occlusions in both lower extremities, with no other identifiable risk factors for ALI. Management included intravenous heparin therapy and 3 attempts at right leg revascularization through percutaneous angioplasty, mechanical thrombectomy, and pharmacologic thrombolysis. After failed revascularization and subsequent rhabdomyolysis, right below-knee amputation was required. Amputation was successful, and the patient underwent rehabilitation with no complications. This case highlights AAS use as a potential cause of severe vascular complications in young patients. When traditional risk factors for ALI are absent, clinicians should screen for the use of AAS. Early recognition and intervention may prevent limb loss in this population.<\/jats:p>","DOI":"10.1177\/23247096251348908","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T12:18:51Z","timestamp":1765628331000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unforeseen Consequences of Anabolic-Androgenic Steroid Use: Acute Limb Ischemia and Subsequent Amputation\u2014A Case Report and Literature Review"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1780-9409","authenticated-orcid":false,"given":"Alhasan Saleh","family":"Alzubi","sequence":"first","affiliation":[{"name":"Marshall University, Huntington, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelrahman Farag","family":"Abdelwahed","sequence":"additional","affiliation":[{"name":"East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0113-5117","authenticated-orcid":false,"given":"Mohammed S.","family":"Beshr","sequence":"additional","affiliation":[{"name":"Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Shelig","sequence":"additional","affiliation":[{"name":"Marshall University, Huntington, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3405-4447","authenticated-orcid":false,"given":"Hazem","family":"Abozguia","sequence":"additional","affiliation":[{"name":"Marshall University, Huntington, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaden","family":"Daloub","sequence":"additional","affiliation":[{"name":"Marshall University, Huntington, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1092-3565","authenticated-orcid":false,"given":"Zakaria","family":"Alagha","sequence":"additional","affiliation":[{"name":"Marshall University, Huntington, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason P.","family":"Mader","sequence":"additional","affiliation":[{"name":"Marshall University, Huntington, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200434080-00003"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1059473"},{"key":"e_1_3_3_4_2","first-page":"97","article-title":"The toxic torch of the modern Olympic Games","volume":"45","author":"Prendergast HM","year":"2003","unstructured":"Prendergast HM, Bannen T, Erickson TB, Honore KR. 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