Iliac artery endofibrosis FAQS

Rob Hinchliffe is professor of vascular surgery at the University of Bristol.

Q: What are the main symptoms?

A: Persistent lower leg symptoms of cramp and a loss of power in one or both legs might indicate you have it. Riders can also experience ‘pins and needles’ in the foot. But many people won’t ever get symptoms, and some people are able to continue riding without it worsening.

Q: Why is it more common in the left leg?

A: We don’t know, but it’s probably related to the fact that the anatomy is slightly different on the left side of the body.

Q: Are women more susceptible?

A: There have been more high-profile female cyclists with the problem recently, but we can’t say if it’s more common in women. We’d only find out the incidence rate if we could do tests on every elite cycling club in the UK. We don’t know why it progresses in some people but not in others.

Q: Is surgery safe?

A: Yes, and we know that the repairs work well in the immediate years following surgery. Surgery, however, is not suitable for everyone and carries significant risks. Importantly, what we don’t know is if the repairs will last another 60 years. Of course, we can surgically treat problems if they arise, but we’re still unsure how long the initial surgery will last.

Q: Are cyclists more at risk?

A: We should put it into perspective: you’re far more likely to have a serious road accident or break your collarbone than have this condition. I see, on average, two patients a month, and though most are cyclists, that’s not many people in the grand scheme of things. I don’t think we should be screening every cyclist for it.