- Title: Endofibrosis of the External Iliac Artery
- Open Access: Ja
- Language: English
- Year: 2009
- DOI/URL: https://pubmed.ncbi.nlm.nih.gov/19670590/
- Publication Date: 01-05-2009
- Journal: JBR-BTR: Organe de la Société Royale Belge de Radiologie (SRBR)
- Pubmed ID: 19670590
A 25-year-old male professional cyclist presented with claudication at his left leg. He consulted his sports physician two months ago with lumbalgia and ischiatiform pain at his left leg.
MRI of the lumbar spine was performed and did not reveal any lesion. He then consulted his physician again because of aggravating acute claudication symptoms during his cycling activity. History reveals worsening stress induced claudication during his sports activities since several years. Blood pressure investigation before and after stress and left and right differential and arm leg differential blood pressure were not investigated because of the acute clinical presentation.
- Title: SIR 2008 Annual Meeting Film Panel Case: Arterial Endofibrosis
- Open Access: Ja
- Language: English
- Year: 2008
- DOI/URL: https://doi.org/10.1016/j.jvir.2008.04.018
- Publication Date: 01-09-2008
- Journal: Journal of vascular surgery and interventional radiology
- Pubmed ID: 18725087
The patient was a 31-year-old Armenian-American woman, single and nulliparous. She was an avid amateur athlete, formerly successful in competitive long-distance running and road bicycling. She had a 2-year history of bilateral thigh claudication during strenuous athletic activity, now resolved on the left but persisting on the right. She stated that her pain and tightness were centered “over the sartorius,” initially only during competitive athletics but now even with leisurely biking and running. The pain reliably resolved after a few minutes of rest, and never involved the calves or buttocks. The pain and restriction of endurance were sufficient to force her to discontinue participation in competitions.
- Title: Iliac Artery Endofibrosis in Athletes: A Case Series
- Open Access: Nee
- Language: English
- Year: 2008
- DOI/URL: https://doi.org/10.1177/154431670803200402
- Publication Date: 01-01-2008
- Journal: Sagepub - Vascular Medicine
Introduction
Endofibrosis of the external iliac arteries (IE) occurs in some high-performance athletes, particularly female cyclists, and causes leg pain on extreme exertion. Establishing the diagnosis in these cases is challenging, because a vascular cause is often not suspected initially. The anatomic lesion of IE is difficult to detect with B-mode ultrasound because of the characteristic smooth and diffuse thickening of the arterial wall. Standard treadmill testing can be equivocal in these athletes, but more intense or “extended” treadmill exercise can demonstrate the physiological abnormalities.
Case Report
This report describes our experience with 6 limbs of 4 patients found to have IE and who also underwent surgical intervention to relieve symptoms. All patients had normal resting ankle/brachial indices, except one, who also had iliac artery thrombosis. Duplex scanning showed diffusely increased velocities throughout external iliac segments. The treadmill exam was modified, with speeds ranging from 2.5 to 5.8 mph and exercise times up to 15 minutes required to provoke a significant decrease in ankle pressure. Monophasic, high-velocity postexercise Doppler flow waveforms helped to localize the site of the responsible lesions.
Results
All 6 limbs were treated by enlarging the affected external iliac artery with a vein patch angioplasty (thrombectomy was also performed in one patient). Inspection of the arterial lumen at surgery revealed a smooth, fibrous-appearing lesion with diffuse wall thickening. The 5 limbs, which had postoperative treadmill tests, all had normal results and these patients resumed athletic training. Among 5 limbs with postoperative duplex scans, 2 showed normal vessel diameter, and 3 had a dilated lumen.
Conclusion
Although the mechanism of IE is not known, the typical history and location of the lesions suggests that repetitive stress or bending of the vessels and high flow during extreme exercise leads to thickening of the arterial wall. Awareness of this entity and a modified vascular testing protocol are essential to establishing the diagnosis.
- Title: Isquemia crónica dos membros inferiores, de etiologia não aterosclerótica, em desportistas jovens
- Open Access: Nee
- Language: Portugese
- Year: 2008
- Publication Date: 01-01-2008
- Journal: Revista Portuguesa Cirurgia Cardio Torácica Vascular
Although rare, the iliac endofibrosis and the popliteal artery entrapment syndrome are undoubtfully recognized as causes of intermittent claudication in young patients, particularly in athletes. The authors report the clinical case of a young female athlete, with disabling claudicaton of the right lower limb due to a stenosis of the external iliac artery and a case of an acute ischemia in a male cyclist owing to an extrinsic compression of the popliteal artery by anomalous muscular bundles. Both cases underwent successfull surgical management.
The early suspicion and diagnosis of these situations is of utmost importance to prevent complications that may be particularly severe.
- Title: External iliac artery endofibrosis in an amateur runner: hemodynamic, angiographic, histopathological evaluation and percutaneous revascularization
- Open Access: Ja
- Language: English
- Year: 2007
- DOI/URL: https://doi.org/10.1177/1358863x07080844
- Publication Date: 01-08-2007
- Journal: Sagepub - Vascular Medicine
- Pubmed ID: 17848477
We describe a case of external iliac artery endofibrosis in an amateur competitive runner. The diagnosis was made by a combination of hemodynamic, angiographic and histopathological assessment and percutaneous revascularization was performed using a balloon expandable stent.