Keywords
acute ischemia
exercise-induced endofibrosis
ciclyst endofibrosis
How to Cite
Abstract
Exercise-induced iliac endofibrosis (IE), initially known as cyclist iliac endofibrosis, is a low prevalence disease that presents characteristic symptoms of ischemia in patients without classical risk factors. We present a 45-year-old triathlete female patient. She consulted for intermittent claudication at 100 m in the lower right limb for about one year. She presented to the consultation with right external iliac artery thrombosis. Endarterectomy and plastic with vein patch were performed with favorable evolution. Iliac endofibrosis is a rare disease but it is one of the diagnoses to consider when dealing with young athlete patients with symptoms of lower limb ischemia.
References
Rouvière O, Feugier P, Gutiérrez JP, Chevalier JM. Arterial endofibrosis in endurance athletes: angiographic features and classification. Radiology. 2014 Oct;273(1):294-303. doi: 10.1148/radiol.14130882. Epub 2014 Jun 19. PMID: 24955926.
Walder J, Mosimann F, Van Melle G, Mosimann R. A propos de I’endofibrose iliaque chez deux coureur cyclistes. HerChir Acta 1984; 51 :793-795.
Chevalier JM, Enon B, Walder J et al., “Endofibrosis of the external iliac artery in bicycle racers: an unrecognized pathological state,” Annals of Vascular Surgery, vol. 1, no. 3, pp. 297–303, 1986.
Vink A, Bender M, Schep G, van Wichen D, de Weger R, Pasterkamp G, et al. Histopathological comparison between endofibrosis of the high-performance cyclist and atherosclerosis in the external iliac artery. J Vasc Surg. 2008;48(6):1458-63.
Wright IA, Pugh ND, Goodfellow J, Wood AM, Lane IF, Fraser AG. Dynamic obstruction of the external iliac artery in endurance athletes and its relationship to endothelial function: the case of a long distance runner. Br J Sports Med. 1997 Jun;31(2):156-8. doi: 10.1136/ bjsm.31.2.156. PMID: 9192135; PMCID: PMC1332623.
Scavèe V, Stainier L, Deltombe T, Theys S, Delos M, Trigaux JP, Schoevaerdts JC. External iliac artery endofibrosis: a new possible predisposing factor. J Vasc Surg. 2003 Jul;38(1):180-2. doi: 10.1016/ s0741-5214(03)00123-x. PMID: 12844109.
Shalhub S, Zierler RE, Smith W, Olmsted K, Clowes AW. Vasospasm as a cause for claudication in athletes with external iliac artery endofibrosis. J Vasc Surg. 2013 Jul;58(1):105-11. doi: 10.1016/j. jvs.2012.12.060. Epub 2013 Mar 29. PMID: 23541546.
Alimi YS, Accrocca F, Barthèlemy P, et al. Comparison between duplex scanning and angiographic findings in the evaluation of functional iliac obstruction in top endurance athletes. Eur J Vasc Endovasc Surg 2004;28:513-9.
Schep G, Kaandorp DW, Bender MH, et al. Magnetic resonance angiography used to detect kinking in the iliac arteries in endurance athletes with claudication. Physiol Meas 2001;22:475–87.
Cai TY, et al. Functional magnetic resonance angiography in the diagnosis of iliac artery endofibrosis in an endurance runner BMJ Case Rep 2019;12:e232112. doi:10.1136/bcr-2019-232112.
Peake LK, et al. The Investigation and Management of Iliac Artery Endofibrosis: Lessons Learned from a Case Series, European Journal of Vascular and Endovascular Surgery (2018), https://doi.org/10.1016/j. ejvs.2018.01.018
Zugail AS, Shaabi HI, Idir S, Becquemin JP. Cyclist Endofibrosis
(Exercise-Induced Arterial Endofibrosis) Treated by Drug-Coated Balloon Angioplasty. Case Rep Vasc Med. 2020 Jul 7;2020:4290271.
Wijesinghe LD, Coughlin PA, Robertson I, et al. (2001) Cyclist iliac syndrome: temporary relief by balloon angioplasty. Br J Sports Med 35:70-71.
INSITE. Diagnosis and Management of Iliac Artery Endofibrosis: Results of a Delphi Consensus Study. Eur J Vasc Endovasc Surg (2016) 52.