I came across this article recently and thought it might be of interest to some. After last year’s 'trial' (gut issues and nerve damage), an older cyclist like me cannot rule out anything I guess.
Most elite athletes are accustomed to experiencing a certain degree of muscle pain and fatigue during high intensity exercise. Recently, however, a subset of athletes (particularly cyclists, rowers and triathletes) have reported symptoms of leg pain and weakness from an unexpected cause - damage to the arteries of the pelvis, groin or lower leg.
This damage, or arteriopathy appears to cause the arteries to stretch, narrow or kink in such a way that during high-intensity exercise the athlete experiences decreased blood flow due to the constriction or obstruction of the artery in the affected leg. This lack of blood flow, or ischemia, causes pain, burning, weakness, and powerlessness during exercise. In cyclists this damage most often occurs in the iliac arteries, particularly the external iliac artery.
A cardiac surgeon comments on the treatments mentioned in the article:
Interesting problem, the treatment from a vascular surgery standpoint should NOT involve a stent. When I did this type of surgery the best long term procedure is removal of the stenosis via endarterectomy and patching with bovine pericardium (tanned with glutaraldehyde rendering it rejection free to the body).
Using a vein patch is ill advised in my opinion, because of the risk of aneurysm formation at the patch site secondary to the vein not being up to the stresses put upon it.