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External iliac artery endofibrosis in athletes
P Abraham1, J L Saumet, J M Chevalier
1Laboratoire d'Explorations Vasculaire et de Médecine du Sport, C.H.U. d'Angers, France.
Sports Medicine (Auckland, N.Z.)
|October 27, 1997
Summary
Iliac arterial endofibrosis affects young cyclists, causing leg swelling during exercise. Diagnosis involves low ankle-brachial index post-exercise, with surgery offering return to competition.
Area of Science:
- Vascular Surgery
- Sports Medicine
- Cardiovascular Research
Background:
- Iliac arterial stenosis is increasingly reported in young competition cyclists.
- This condition, termed arterial endofibrosis, presents with specific intimal wall fibrosis, distinct from atherosclerosis or inflammatory diseases.
- Symptoms include exercise-induced thigh swelling, often with normal resting vascular assessments.
Purpose of the Study:
- To investigate the characteristics and diagnosis of iliac arterial endofibrosis in cyclists.
- To evaluate the efficacy of surgical interventions for this condition.
- To explore the unknown physiopathology and potential links to atherosclerosis.
Main Methods:
- Clinical evaluation of exercise-related leg symptoms.
- Doppler investigations at rest.
- Ankle-brachial systolic pressure index measurement following maximal exercise.
- Arteriography for diagnosis.
- Surgical interventions including saphenous grafts and angioplasty-endofibrosectomy.
Main Results:
- 85% of affected individuals exhibit an ankle-brachial systolic pressure index below 0.5 after maximal exercise.
- Surgery appears effective for enabling an early return to cycling competition.
- Long-term surgical outcomes require further evaluation.
Conclusions:
- Iliac arterial endofibrosis is a distinct condition in young cyclists characterized by intimal fibrosis.
- Post-exercise ankle-brachial index is a key diagnostic indicator.
- Surgical treatment facilitates return to sport, though long-term efficacy needs assessment.