ROME -- Paralympic champion Alex Zanardi was seriously injured in a handbike crash Friday -- nearly 20 years after losing both of his legs in a horrific auto racing accident.
Zanardi was transported by helicopter to Santa Maria alle Scotte hospital in Siena following an incident near the Tuscan town of Pienza during a national race for Paralympic athletes, police told The Associated Press.
A medical bulletin from the hospital said Zanardi's condition is "very serious" due to "severe cranial trauma" and that after being placed in a shock room he was undergoing "a delicate neurosurgery operation."
"You've never given up and with your extraordinary strength within you've overcome a thousand troubles. Forza Alex Zanardi," Italian Premier Giuseppe Conte tweeted. "Don't give up. All of Italy is with you."
A Carabinieri police official in Montepulciano said the incident involved a "heavy vehicle."
Local TV at the scene of the crash showed what was apparently Zanardi's handbike lying on its side and missing two of its three wheels. A large truck pulling a semitrailer appeared parked on the road ahead.
"It happened on a slightly downhill straightaway just before a slight curve in the road," national team coach Mario Valentini, who was following the race, told La Repubblica Florence. "Alex veered slightly into the oncoming lane just when a truck came. [The truck] tried to swerve but couldn't avoid the crash."
Repubblica said Zanardi remained conscious until medical personnel arrived and that he was breathing by himself.
"Twenty minutes passed from the time of the accident to when the medical personnel arrived. It took some time to load him [into the ambulance]," Valentini added in another interview with local media. "His wife helped. After the accident he was talking."
Valentini said he was not an eyewitness to the crash but arrived at the scene immediately afterward.
"It was a sunny day and everyone was happy. We were 20 kilometers from [the finish line] in Montalcino," Valentini said. "The truck didn't make a mistake. Alex made the mistake."
The coach added that Zanardi's helmet came off during the crash.
"I am so anxious and frightened about Alex Zanardi that I'm holding my breath," racing great Mario Andretti tweeted. "I am his fan. I am his friend. Please do what I'm doing and pray for this wonderful man."
Zanardi, 53, won two championships in CART in the United States before a brief move to Formula One. He returned to America and was racing in Germany in a CART event when both of his legs were severed in a horrific crash the weekend after the Sept. 11 terrorist attacks. CART raced only because the series was already in Germany at the time of the attacks and could not return to the U.S.
During his recovery, Zanardi designed his own prosthetics -- he jokes he made himself taller -- and learned to walk again. He turned his attention to hand cycling and developed into one of the most accomplished athletes in the world. He won four gold medals and two silvers at the 2012 and 2016 Paralympics, competed in the New York City Marathon and set an Ironman record.
His spirit, will and determination gave the beloved Italian a larger-than-life persona. When he returned to the U.S. in 2019 to compete for BMW at the Rolex 24 of Daytona without his prosthetics, he was the most revered driver in a field that included F1 champion Fernando Alonso.
Drivers from around the world sought out Zanardi for photographs and were transfixed as he told elaborate, often embellished, tales of his adventures in the nearly two decades since many had seen him.
Noted for his infectious smile and fanciful storytelling, Zanardi proved time and again to be among the most determined people his peers have ever known.
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