Fabio Aru: When the iliac artery problem was diagnosed, I cried

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Fabio Aru has admitted that he cried due to the frustration and suffering of recent months and cried again last week when specialists finally diagnosed a constriction of the iliac artery as the reason why he was unable to race successfully.

The UAE Team Emirates rider will soon undergo surgery and will miss the Giro d’Italia and much of the 2019 season but he was happy to have finally found an explanation why he was unable to perform at the level that allowed him to win the 2015 Vuelta a Espana.

“There were days when I felt dead on the bike. I was devastated. I felt terrible and even worse because I didn’t know why,” Aru explained to La Gazzetta dello Sport after UAE Team Emirates confirmed Aru’s problem on Sunday.

“The hair stands up on my arms as I talk about it but when the iliac artery problem was diagnosed, I cried. Only a few people know how much I’ve suffered. Despite total dedication I couldn’t get anywhere near my usual level. I wasn’t myself and so it was impossible to be happy. A tenth place in a race felt like a victory… but I don’t race to finish tenth.”

Aru was due to ride this week’s Volta a Catalunya after abandoning Paris-Nice but he now faces several months out of action.

Aru's unexplained decline had sparked a huge debate in Italy about why the 28-year-old Sardinian rider had struggled to confirm his early Grand Tour potential. He is considered the natural heir to Vincenzo Nibali and one of the few riders capable of flying the flag for Italy at WorldTour level and especially in Grand Tours.

Long hours in the saddle often lead to internal muscles squeezing the iliac artery and reducing blood flow. Usual treatment includes the insertion of a stent or angioplasty surgery to widen the artery and so clear any blockage. However according to La Gazzetta dello Sport, professional athletes are often advised to undergo a bypass operation with a new section of synthetic or natural vein inserted in the leg to avoid a repeat of the problem and to allow a full recovery.

Surgery ends the suffering

Riders who have had iliac-artery operations in recent years include EF Education First's Joe Dombrowski, 2014 road race world champion Pauline Ferrand-Prévot and current time trial world champion Annemiek van Vleuten (Mitchelton-Scott).

Recently appointed head of the medical staff at UAE Team Emirates, Dr Jeroen Swart said Aru would undergo angioplasty surgery.

"In the coming days, with a date to be determined based on the availability of the hospital, Aru will undergo angioplasty surgery at the Nuovo Ospedale di Prato [Prato hospital], after which he will have to observe an absolute rest period of one month," Swart said.

Aru will then make a very gradual return to training and competition. For now he is just happy his suffering has an explanation and an end.

“I’ve suffered like a dog recently. People could have thought I was struggling mentally but in truth I was able to handle it even if it was hugely frustrating,” Aru said.

“I only usually cry when I’m incredibly happy but this was a hard moment in my life, really hard. I hope people can understand that.”