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Pauline Ferrand Prevot's Iliac Endofibrosis Returns

Jan 7, 2020
by James Smurthwaite  
Pauline Ferrand Prevot gave it her all and showed a glimpse of a return to her pace with a battling 15th place.

Pauline Ferrand Prevot has announced on Instagram that her iliac endofibrosis has returned just over a year after her first diagnosis.

Prevot has apparently been struggling with power in her lower left leg while racing cyclocross for the past 2 weeks and went for a scan yesterday. The doctors confirmed that it was another endofibrosis and, although it is a smaller lesion than last time, it will still require surgery. She is due to have the surgery on Friday and then will begin recovery for the race season.

Iliac Endofibrosis is damage to the layers of the artery wall, which leads to decreased blood flow through the legs and can translate to unprecedented weakness. Last year, Prevot was struggling to push above 70% of her maximum power and unable to maintain a constant power of 200 watts. Unfortunately, recurrence of Iliac Endofibrosis is not uncommon even after surgery. A fifteen-year-long study by three Stanford University MDs in 2016 looked at eighteen patients between 2000 and 2015 who underwent operative intervention, with all of them being high-performance endurance cyclists, triathletes, and long-distance runners. It noted that "82% of patients were able to return to their prior level of physical endurance, in a long-term follow-up survey, 50% of these patients experienced some recurrence of symptoms.''

Last year, Prevot took a four-month break from racing but she returned to win the final World Cup of the year in Snowshoe and the World Championships in XCO and marathon.

We wish Pauline the best with her surgery and hope to see her back on the bike soon.


  • 45 0
 Last year the top 3 dh women were injured. Is the same about to happen to the top xc women in 2020? - hope not! get well Pauline and look forward to watching you race again soon.
  • 26 0
 Not good. She was on top at the end of the season. Both her and Neff has had major setbacks. Hopefully both will be in top shape for the upcoming season and Olympics.
  • 23 0
 Nooooo! One of my favourite riders. PLEASE get well soon.
  • 13 0
 Terrible news. Get well soon, PFP!
  • 5 0
 Déjà vu: Jolanda and Pauline had the same bad luck preparing for Rio 2016 (more info below)… it is happening again four years later. This totally sucks!

Jolanda Neff

Pauline Ferrand-Prevot
  • 4 0
 That's sad news. I was looking forward to seeing an exciting WC season with the women battling it out like they did last year. And of course the Olympics! I wish Pauline a speedy recovery!
  • 2 0
 "eighteen patients between 2000 and 2015 who underwent operative intervention, with all of them being high-performance endurance cyclists, triathletes, and long-distance runners."
Causation, or correlation?
Either way, very unfortunate. At the least, I hope this doesn't drastically affect normal day to day activities.
Best of luck!
  • 4 0
 Causation, at least in the case of cyclists.
  • 4 6
 Perhaps a couch jockey wouldn't notice the inability to maintain 200 watts.
  • 1 1
 Causation. This is 100% a disease of elite athletes.
  • 1 0
 @iamamodel: it’s brought on by repetitive trauma to the artery, so the real issue is that the couch jockey isn’t moving their legs in a way that, combined with their anatomy, would beat up the artery.
  • 5 0
 Et Merde... Courage Pauline
  • 4 0
 This sucks. She worked her ass off to get back to the top and might just do it again. Get well soon!
  • 1 0
 My wife so far has undergone four operations for iliac endofibrosis. Two on each leg/hip. The condition has returned to some extent each time. Fortunately, my wife is still able to ride, but not compete at her previous level. Hopefully, the outlook is more favorable for Pauline.
  • 3 2
 10-15 years ago I used to do the pre and post surgical non invasive testing on highly competitive cyclists who presented with iliac endofibrosis. The outcomes were generally not favorable for the cyclists.
  • 1 0
 Has treatment changed since then?
  • 1 0
 @iamamodel: Not that I am aware of. The surgeon I worked with would remove the affected section of the artery and depending upon the extent of the damage increase the diameter of the artery with a vein or gortex (yes, the same stuff your jacket is made of) patch.
  • 2 0
 @teo7z: Ta. So it it the surgery that fails?

How do you know I have a Gore-Tex jacket? [he types, while looking over his shoulder]
  • 1 0
 @iamamodel: If the end point of the surgery is to allow the athlete to compete at the level prior to onset of symptoms and the athlete cannot, the surgery was considered a failure. The riders I worked with could still ride just not at the same competitive power output for the same duration.

As a rider myself it was tough to watch these very driven athletes accept a more than likely career ending condition.
  • 1 0
 se rétablir sous peu Pauline.

Between Jolanda & PHP I'm about ready to stop reading the cycling news. I hope these tribulations don't come in 3's. [Sarc]
It's getting damn depressing......
  • 2 0
 Ugh well hope she recovers quickly and hopefully won't interfere with Olympics this year.
  • 1 0
 Thats a shame, but it will mean the racing will be unpredictable. Its also an Olympic year, so some may be training with just that in mind.
  • 3 0
 Pffff... That sucks ! Good recovery Pauline !
  • 3 0
 Well that's shit, wishing her a speedy recovery
  • 3 0
 speedy recovery. Hope we get to see you this season.
  • 3 0
 Wow that sucks! Get well Pauline!!!
  • 3 0
 What's the prognosis after a second operation?
  • 3 0
 I remember watching the race...what a comeback. Hope you heal up good.
  • 3 0
 Oh no! Get well soon
  • 2 0
 That's unfortunate, hopefully the prognosis is favorable...
  • 2 1
 What a bummer of an offseason between this, Jolanda, and all the riders losing their jobs.
  • 1 5
flag suspended-flesh (Jan 7, 2020 at 15:30) (Below Threshold)
 If you are good, you get a new 'job' A cold-blooded sports bettor would be putting Olympics money on Kate. Speedy recovery to all injured riders.
  • 1 0
 It worked well once, it'll work well twice. Faut garder la gniaque. Prompt rétablissement.
  • 1 0
 that sucks so bad! i guess rissveds will win gold again in tokyo.
  • 1 0
 Best Wishes and get well soon.
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