Iliac Artery Evaluations in Endurance Athletes
Summary
High-level endurance athletes, particularly cyclists and long-distance runners, are susceptible to unique vascular challenges affecting the external iliac arteries. Repetitive hip flexion, extreme cardiac output and sustained haemodynamic stress may induce intimal thickening, kinking or fibromuscular changes, collectively termed flow limitation of the iliac artery. Affected athletes typically present with exertional lower-limb pain, cramps or power loss, often without traditional atherosclerotic risk factors. Accurate assessment combines dynamic imaging, exercise testing and tissue oxygenation measurements to distinguish functional from structural lesions. Early diagnosis is critical to guide conservative management, targeted endovascular interventions or bespoke surgical repair, with the aim of restoring perfusion, preserving athletic performance and minimising long-term complications.
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Iliac Artery Evaluations in Endurance Athletes publication trend
The graph below shows the total number of articles in iliac artery evaluations in endurance athletes across all publications each year (not limited to Nature Index journals).
Technical terms
Iliac artery endofibrosis: Progressive subintimal fibrosis of the iliac artery leading to flow restriction under exertion.
Claudication: Exercise-induced pain or cramp in a limb due to inadequate blood supply.
Ankle-brachial index: Ratio of ankle to brachial arterial pressures used to quantify peripheral perfusion.
Kinking: Mechanical bending of an artery, often exacerbated by joint movement, causing transient flow limitation.
Near-infrared spectroscopy (NIRS): Optical technique measuring tissue oxygenation dynamics in real time during and after exercise.
References
- Short- and long-term outcomes after endarterectomy with autologous patching in endurance athletes with iliac artery endofibrosis. Journal of Vascular Surgery (2023).
- Near‐Infrared Spectroscopy Is Promising to Detect Iliac Artery Flow Limitations in Athletes: A Pilot Study. Journal of Sports Medicine (2018).
- Surgical shortening of lengthened iliac arteries in endurance athletes: Short-term and long-term satisfaction. Journal of Vascular Surgery (2022).
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