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THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Rivista di Medicina, Traumatologia e Psicologia dello Sport


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The Journal of Sports Medicine and Physical Fitness 2007 March;47(1):91-5

Copyright © 2007 EDIZIONI MINERVA MEDICA

lingua: Inglese

External iliac artery occlusion in a young female cyclist

Korsten-Reck U. 1, Röcker K. 1, Schmidt-Trucksäss A. 1, Schumacher Y. O. 1, Striegel H. 2, Rimpler H. 3, Dickhuth H. H. 1

1 Medical Clinic Department of Rehabilitative and Preventive Sports Medicine University of Freiburg, Freiburg, Germany
2 Medical Clinic, Department of Sports Medicine University of Tuebingen, Tuebingen, Germany
3 Department of Thoracovascular Surgery Clinic Friederichshain, Berlin, Germany


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After 8 years of high performance training in mountain biking, a top female athlete, aged 23, first complained of diffuse, exercise-induced pain in both thighs. Over a period of the next 4 years, a slight but continuous reduction in her performance was observed, despite having maintained her training regime during the first 2 years. Gradually, pain increased, at last occurring even when she climbed a few stairs. This led to a clinical, echo-Doppler, MR-angiographic and DS-angiographic examination, which showed a complete occlusion of the right iliac external artery with good collateralisation. The left external iliac artery evidenced only small intravascular lesions. Surgical treatment (endarterectomy plus patch angioplasty) eliminated the pain completely. Except for a lipoprotein (a) of 114 mg/dL, no other significant risk factors were found. The influence of a genetic (heterocygotic) low APC-ratio of 1.6 and free protein S of 53% is unclear. This is a typical case of a delayed diagnosis in an athlete. A complete occlusion of an external iliac artery is extremely seldom in young in female athletes. With no indication of a general atherosclerotic or inflammatory process nor congenital abnormalities, an exercise-induced, chronic traumatisation may have caused this pathological condition.

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