Iliac Artery Endofibrosis in a Middle-Aged Female Long-Distance Runner

Abstract

Exercise-induced iliac artery endofibrosis is a recently described abnormality of the external iliac artery that typically affects younger, healthy endurance athletes. Characteristic of the initially termed cyclist's iliac syndrome is lower limb pain during exercise with rapid recovery after exercise. This clinically complicated case describes an older female long-distance runner in whom an incorrect diagnosis of fibromuscular dysplasia was originally made when she presented with claudication and thrombosis of the right external iliac artery. A thrombectomy and bilateral balloon angioplasty were performed; however, her symptoms persisted. Four months later, she unexpectedly complained of dual calf claudication, a diagnosis of exercise-induced iliac artery endofibrosis was made, and a bilateral prosthetic graft bypass procedure was performed, which resulted in a good outcome.

Intensive Long Distance Running as a Possible Cause of Multiple Splanchnic Arterial Aneurysms: A Case Report

“…Long-distance running has been implicated as a cause of various cardiovascular and gastrointestinal disorders or abnormalities, such as iliac artery endofibrosis [ 7 , 8 ], lower leg artery stenosis or occlusion [ 9 ], arterial dissection [ 10 ], left sided ventricular hypertrophy [ 11 ], increased vascular compliance [ 12 ], ischemic colitis [ 13 , 14 ], hyponatremia [ 15 ], myoglobinuria, increased troponin, leukocyte abnormalities [ 16 ], coagulopathy and sudden death [ 17 ]. A reduced arterial compliance and stiffness can induce endofibrosis or stenosis in the aorta, large arteries and visceral arteries of long distance runners.…”

Dissecting aneurysm of common iliac artery in a long-distance runner

“…In contrast to atherosclerosis, there is a poor response to balloon angioplasty in endofibrotic lesions, and stent implantation is necessary in most cases. Afterward, remaining compression due to muscle hypertrophy often results in recurrent stenosis with disappointing long-term results 12 . For these reasons, we were afraid of such complications as stent graft compression and endoleaks and decided against endovascular and for surgical management.…”

Debilitating Claudication in an Ultramarathon Runner: A Case of Iliac Artery Endofibrosis

“…[2][3][4] However, there also have been a few cases reported with high performance athletes, including triathletes and long-distance runners. 5,6 The etiology of this condition is thought to be secondary to mechanical kinking of the external iliac artery during repetitive deep flexion movements, which is seen in certain endurance sports such as cycling or long distance-running. 7 This is a case of a 43-year-old previous cyclist, now ultramarathon runner, who presented to clinic with severe and progressive exertional lower extremity pain.…”