Journal ArticleDOI
Magnetic resonance angiography used to detect kinking in the iliac arteries in endurance athletes with claudication
TLDR
It can be concluded that flow limitations in the iliac arteries in endurance athletes are associated with kinkings in the common and/or the external iliAC arteries.Abstract:
In endurance athletes, leg complaints upon maximal exercise caused by flow limitations in the iliac arteries are frequently encountered. We theorize that functional kinking of the vessels, which occurs especially during hip flexion, may be a cause for such flow limitations. Conventional diagnostic tests cannot demonstrate such kinkings. Using gadolinium-enhanced magnetic resonance angiography, a 3D dataset of the aorto-iliac arteries could be obtained with the hips flexed. An image processing procedure was developed using a new segmentation algorithm to be able to use standard surface rendering techniques to visualize the arteries with an improved 3D appearance. These techniques were applied in the current study in 42 endurance athletes with documented flow limitations in the iliac arteries. As a control group 16 national level competitive cyclists without flow limitations in the iliac arteries were studied. Forty-six affected legs were examined in 42 patients. In all patients and reference persons image quality was adequate and the segmentation algorithm could be applied. In 22 affected legs (48%) a kinking in the common iliac artery could be demonstrated, compared with one leg (3%) in the control group. In 13 affected legs (28%) a kinking in the external iliac artery could be demonstrated, compared with three legs (9%) in the control group. It can be concluded that flow limitations in the iliac arteries in endurance athletes are associated with kinkings in the common and/or the external iliac arteries. Magnetic resonance angiography with the hips flexed followed by this newly developed segmentation algorithm is effective to visualize and score these kinkings.read more
Citations
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Journal ArticleDOI
Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms
TL;DR: A new hypothesis that mechanical instability and remodeling could be mechanisms for the initiation and development of these tortuous vessels is submitted.
Journal ArticleDOI
Endofibrosis and kinking of the iliac arteries in athletes: a systematic review.
TL;DR: A systematic review of the literature together with a proposed algorithm for diagnosis and management of these iliac flow limitations in endurance athletes is presented.
Journal ArticleDOI
Non-Traumatic Lower Limb Vascular Complications in Endurance Athletes. Review of Literature
TL;DR: Non-traumatic vascular complications affecting the lower limbs include endofibrosis, stenosis/kinking of iliac arteries, dissection of external iliAC arteries, adductor canal syndrome, popliteal entrapment syndrome, chronic exertional compartment syndrome and effort-induced venous thrombosis.
Journal ArticleDOI
Color Doppler used to detect kinking and intravascular lesions in the iliac arteries in endurance athletes with claudication.
TL;DR: Both kinks and intravascular lesions are associated with flow limitations in the iliac arteries in endurance athletes and color Doppler appears to be an effective technique to visualize and scale kinks.
Journal ArticleDOI
Sports-related flow limitations in the iliac arteries in endurance athletes: aetiology, diagnosis, treatment and future developments.
TL;DR: As both the diagnostic methods and the treatments for this type of flow limitation differ substantially from routine vascular procedures, these patients should be examined in specialised research centres with appropriate diagnostic tools and medical experience.
References
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Journal ArticleDOI
Endofibrosis of the External Iliac Artery in Bicycle Racers: an Unrecognized Pathological State
Jean-Michel Chevalier,Bernard Enon,Jean Walder,Xavier Barral,Jean Pillet,Armand Megret,Philippe L'Hoste,Jean-Pierre Saint-André,Michel Davinroy +8 more
TL;DR: Under certain predisposing anatomic conditions, abnormal hemodynamics, probably due to a high flow arterial state and an aerodynamic position on the bicycle, provoke repeated trauma which eventually produces the lesion.
Journal ArticleDOI
Evidence for restricted muscle blood flow during speed skating.
Carl Foster,Kenneth W. Rundell,Ann C. Snyder,James Stray-Gundersen,Gerard Kemkers,Nick Thometz,Jeff P. Broker,Elizabeth Knapp +7 more
TL;DR: The hypothesis that physiological responses during speed skating are dominated by restriction of blood flow, attributable either to high intramuscular forces, the long duty cycle of the skating stroke, or both is supported.
Journal ArticleDOI
Stenotic intimal thickening of the external lliac artery in competition cyclists
Marie-Christine Rousselet,Jean-Paul Saint-André,Philippe L'Hoste,Bernard Enon,Armand Megret,Jean-Michel Chevalier +5 more
TL;DR: Stenotic intimal thickening of the external iliac artery appears to be a new arterial disease defined by clinical, arteriographic, and pathologic features.
Journal ArticleDOI
Flow limitations in the iliac arteries in endurance athletes. Current knowledge and directions for the future.
TL;DR: Pain and powerless feeling in the leg during cycling may indicate a serious problem that limits the performance in cyclists, and available diagnostic techniques are proven to be inadequate for this specific lesion, which has characteristics other than those of atherosclerotic lesions.
Journal ArticleDOI
Lower Extremity Arterial Disease in Sports
TL;DR: Invasive investigations (arteriography or an gioscopy) will confirm the diagnosis before surgery is discussed, and long-term results in endofibrosis are unknown, most of the surgically treated patients return to competition.