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

Janse van Rensburg, Dina Christina MD, FACSM; Jansen van Rensburg, Audrey MSc; van Duuren, Elsa Margaretha MMed, MBChB; Grant, Catharina Cornelia PhD

American Journal of Physical Medicine & Rehabilitation: December 2014 - Volume 93 - Issue 12 - p 1100–1103
doi: 10.1097/PHM.0000000000000175
Case Reports

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case describes an older female long-distance runner in whom an incorrect diagnosis of fibromuscular dysplasia was originally made when she presented with claudication and thrombosis of the right external iliac artery.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.

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.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins