Femoral Artery Stenosis in a Marathon Runner

Abstract

The diagnosis of arterial pathology in an athlete is challenging for the clinician. Their symptoms are commonly attributed as being musculoskeletal in origin. Typically, athletes with arterial pathology have normal resting examinations and are not symptomatic unless they are performing extreme physical exertion. This case study describes a marathon runner who, over a 12-month period, complained of severe heaviness and dead sensation in her right lower extremity after running one-half mile that resolved with rest. By customizing usual vascular lab indirect physiological testing and duplex imaging protocols, we were able to identify and quantify the femoral artery narrowing that was ultimately repaired with surgery. This case demonstrates the efficacy of the vascular laboratory in identifying performance limiting atypical arterial pathology in a marathon runner.