Paracyclist Alex Zanardi is in intensive care following a collision with a truck while taking part in the 'Obiettivo tricolore' relay race in Siena. The Italian suffered serious head and neurological injuries in the accident and has been placed in an induced coma following surgery on Friday night.
The 53-year-old handcyclist, a four-time Paralymic gold winner, was riding with ex-road pro Daniele Bennati on Friday afternoon when he lost control on a downhill section and collided with a truck on the other side of the road.
Since being airlifted to the Siena University Hospital, Zanardi has undergone a near-three-hour "neurosurgical and maxillofacial [jaw and face] intervention" and is currently in a "stable but serious" condition in intensive care.
According to a press release issued by the hospital on Saturday morning, Zanardi "has stable hemodynamic and metabolic parameters. He is intubated and supported by artificial ventilation while the neurological picture remains serious."
Italian national para-cycling coach Mario Valentini, who was following the race in a minivan, said that Zanardi had flipped over on the descent near Pienza, adding that the truck had attempted to avoid him.
"The stage finished in Montalcino; we were almost there," he told Corriere della Sera. "We were on a curve, on a not-difficult descent, going around 50kph. Alex lost control of the handbike, overturned twice, and collided with a truck.
"The impact was terrible, very serious. Paramedics recovered him, but the helicopter couldn't land [the accident occurred a wooded area – Ed.] so the ambulance took him to a nearby parking lot where the helicopter managed to take off and take him to Siena."
Giuseppe Oliveri, director of neurosurgery at the hospital, gave an update on Zanardi's condition on Saturday.
"He arrived with facial fracture and a sunken fracture of the frontal bones," Oliveri told Corriere della Sera. "He will have to remain sedated and ventilated, allowing the secondary damage as a result of the trauma to stabilise over time.
"The improvement, if any, will be very slow over time. And assessments of the neurological situation will be made when he wakes up, if he wakes up. It is useless to speculate today how it will go – I just know that I am absolutely convinced that it is worth treating him."
Local prosecutors have opened a criminal investigation into the accident, also looking at the organisation of the race and the safety precautions in place at the time. The driver of the truck is also under investigation – a necessary precaution said chief prosecutor Salvatore Vitello – and the influence of alcohol and drugs has been ruled out.
Zanardi, who raced in Formula 1 and the American CART series during the 1990s, has famously overcome life-threatening injuries before, having lost both of his legs in a CART crash at the Lausitzring in Germany in 2001.
During his long recovery from the crash, Zanardi helped to design his own prosthetics and eventually returned to auto racing, competing – and winning – in the World Touring Car Championship between 2005 and 2009.
Zanardi's second sporting career has come in the discipline of handcycling, which he took up in 2007. He has since enjoyed great success on the bike, winning the Venice, Rome and New York marathons, 12 Para-cycling World Championship titles and four Paralympic golds across the 2012 and 2016 Games in London and Rio de Janeiro.
Daniele Bennati took to Instagram to show support for Zanardi on Friday: "I still don't believe it, nobody believes it, just before that damned half-curve you said: 'guys, today is one of the best days of my life' and I thought the same thing... all those who rode with you to Montalcino thought the exact same thing because you know how to convey happiness, positivity and joy! We are all with you Alex."
Rocco di Renato, the President of the Italian Cycling Federation, also wished Zanardi well, saying that "his example has been a source of inspiration for many of us and now is the time to make him feel all the warmth of our world."
Italian Prime Minister Giuseppe Conte and UCI President David Lappartient added to the messages of encouragement on social media.
