Dominique Stephan: Recreational Nitrous Oxide Use as a Risk Factor for VTE
Dominique Stephan, Professor at Strasbourg Hospital University, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Annals of Vascular Surgery, adding:
“Recreational nitrous oxide use: an underrecognized cause of venous thromboembolism.
Recreational use of nitrous oxide (N₂O) is rapidly increasing, particularly among young adults, and is often perceived as harmless.
We report a case of pulmonary embolism in a 25-year-old man with heavy recreational N₂O use and no conventional thrombotic risk factors.
The mechanism is increasingly well documented:
- functional vitamin B12 inactivation
- severe hyperhomocysteinemia
- prothrombotic state leading to venous thromboembolism
While neurological complications of N₂O misuse are well known, vascular and thromboembolic events remain largely underdiagnosed.
Clinical take-home messages:
- consider nitrous oxide use in young patients with unexplained VTE
- systematically assess homocysteine and vitamin B12 levels in this context
- raise awareness of this emerging and preventable risk factor
As N₂O misuse continues to grow, early recognition and prevention are key.”
Title: Pulmonary embolism associated with recreational nitrous oxide use: a case report
Authors: Camille Zampérini, Elena-Mihaela Cordeanu, Dominique Stephan

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