Vaskulárna medicína 1/2023

Iliac artery endofibrosis in a recreational cyclist

Introduction: Endofibrosis is a disease that affects the arterial system, predominantly the external iliac artery (AIE) and in 90 percent cyclists. Mechanical factors such as hip hyperflexion and flexion of the artery, muscle hypertrophy in athletes and hemodynamic factors such as increased cardiac output underlie the development of the disease. In addition to physical examination, the basic diagnostic methods include MR angiography. Therapeutic options are both surgical and endovascular, but the results speak in favor of surgical management. The aim: To provide the reader with our own experience of the diagnosis, surgical treatment, and overall management of a patient, a recreational cyclist with this disease. Case report: We present the case of a patient, an amateur cyclist, diagnosed with endofibrotic iliac remodeling and subsequent surgical treatment with a Vollmar ring dissector, as well as the diagnostic procedure that was chosen for the patient. Conclusion: It should be emphasized that although this is a rare disease, its estimated prevalence is up to the 20th percentile of all unilateral lower limb chronic pain in cyclists. We therefore consider it important to raise awareness of this issue not only among vascular specialists, but also among sports physicians, orthopaedists, traumatologists, and, of course, general practitioners.

Keywords: endofibrosis, external iliac artery, cyclist, sportsmen, Vollmar ring disector