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Dr Samuel Maraffi Discusses Iliac Artery Endofibrosis in Cyclists
Team TotalEnergies‘ team physician discusses external iliac artery endofibrosis, a condition that regularly affects high-level professional cyclists, as athlete health takes priority over competitive performance while the team prepares to unveil its new title sponsor on November 10 at 11:30 a.m.
- External iliac artery endofibrosis causes blood flow reduction during high-intensity exercise without showing any symptoms at rest.
- Diagnosing the condition requires specialized centers to measure blood flow immediately after a cyclist pedals to the point of pain.
- Team TotalEnergies medical staff stress that athlete health and proper nutrition take priority over expensive equipment upgrades.
As the Team TotalEnergies formation led by president Jean-René Bernaudeau and general manager Stéphane Heulot prepares to announce its upcoming title sponsor on November 10 at 11:30 a.m., attention is turning to the long-term health of its riders, cyclismactu.net reported. A new chapter for the Vendée-based team is underway. Beyond the immediate sporting and economic pressures, rider welfare remains a central focus for the organization.
Team physician Dr. Samuel Maraffi spoke with cyclismactu.net about external iliac artery endofibrosis, a pathology described as rare that regularly affects high-level cyclists, taking up the recent cases of Célia Géry and Sandy Dujardin. The condition narrows the artery, and during effort an ultrasound shows a drop in blood flow.
The condition presents a unique diagnostic challenge because it triggers zero symptoms at rest. Pain, burning sensations, tingling, or sudden power losses manifest only during maximum effort and disappear as soon as the rider stops. According to Dr. Maraffi, sprinters, puncheurs, and climbers alike can develop the condition depending on which efforts strain their bodies most. Riders initially mistake these warning signs for ordinary training fatigue.
Standard ultrasounds and basic scans often fail to detect the restriction because the artery appears normal at rest. Doctors must recreate the exact conditions that trigger the pain by having the athlete pedal until symptoms appear, followed by an immediate ultrasound to capture the sudden drop in blood flow. These assessments require specialized medical centers that remain relatively scarce.
The average age for a diagnosis sits around 26 or 27 years old among riders covering 15,000 to 20,000 kilometers annually. When the pathology becomes disabling, treatment is primarily surgical. Dr. Maraffi described the procedure as a heavy vascular intervention.
Dr. Maraffi pointed out that today we know the condition is more complex, involving multiple factors including arterial length and stiffness, attachment to the psoas muscle, and inflammatory or metabolic triggers. He cautioned against routine screening across the entire professional peloton. Testing asymptomatic riders would likely reveal slightly narrowed arteries in many of them, but operating on asymptomatic individuals is unnecessary.
The medical philosophy rejects shortcuts to performance in favor of foundational health measures. Pointing to dietary habits, adequate rest, and proper medical oversight, Dr. Maraffi noted that riders will readily spend 200 euros on ceramic derailleur pulleys to gain 1.2 watt at 46 km/h while hesitating over a 10-euro vitamin D dosage or a 50-euro dietary consultation.
Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.