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case describes an older female long-distance runner in whom an incorrect diagnosis of fibromuscular dysplasia was originally made when she presented with claudication and thrombosis of the right external iliac artery.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.
From the Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, South Africa (DCJvR, AJvR, CCG); Jacaranda Hospital, Pretoria, Gauteng, South Africa (EMvD); and Exercise SMART, University of Pretoria, South Africa (DCJvR, AJvR, CCG).
All correspondence and requests for reprints should be addressed to: Dina Christina Janse van Rensburg, MD, FACSM, PO Box 12651, Hatfield 0028, South Africa.
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