Iliac Endofibrosis

What is it?

Iliac endofibrosis is a narrowing (and sometimes kinking) of the main artery of the leg in young athletic people. The iliac artery provides most of the blood supply to the leg and extends from the groin deep inside the tummy to the main blood vessel (the aorta). Narrowing reduce the blood flow to the leg which is most noticeable during times of heavy exercise.

Why does it occur?

No one understands exactly why this condition occurs. It is a condition which has been encountered mainly in elite athletes, especially cyclists. The narrowing of the iliac artery is caused by a different disease process to the narrowing of arteries which normally causes blocked arteries in the heart or legs (atherosclerosis). Atherosclerosis is usually found in older people who smoke or have raised cholesterol, high blood pressure or diabetes. It is possible that the extreme blood flow and repetitive flexing of the hip during extreme exercise somehow damages the iliac artery during which causes narrowing of the artery.

What problems can it cause?

People with iliac endofibrosis often develop fatigue in one leg or cramps during periods of heavy exercise. The symptoms may have been present for many months or years before the diagnosis is made. This is because artery problems in young people are extremely rare and the pain may be put down to muscular problems or back trouble.

Athletes with the condition often find that their performance drops and they are unable to compete to the same level. Others have trouble completing any exercise. Very rarely the iliac artery blocks suddenly causing major interruption of blood flow to the leg. This is an emergency and requires urgent surgery.

Reasons for treatment?

There are various treatment options available. Sometimes a change in cycling position or physiotherapy helps to use other muscles. Some people decide that they do not want to compete at a high level and opt to change sport or cease competition. For others the only option is surgery to remove the narrowing in the artery.

The medical information provided here is intended solely for patients of the London & Surrey Vascular Clinic, it is general information only and should not be used as a substitute for personal advice received when consulting your own surgeon face-to-face.

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