Alex Zanardi’s condition remains serious and there is uncertainty over whether he will recover from the handbike accident in which he was hit by a truck.

The two-time CART champion underwent more than two hours of surgery on Friday night (local time) at the Santa Maria alle Scotte hospital in Siena, Italy, which provided a further update on the following morning.

“Regarding the clinical conditions of the athlete Alex Zanardi, hospitalised from 18 on 19 June in very serious conditions at the Santa Maria alle Scotte polyclinic following a road accident occurred in the province of Siena, the Health Directorate of the Aou Senese informs that the patient, subjected to a delicate neurosurgical intervention on the evening of 19 June, and subsequently transferred to intensive care, he has stable hemodynamic and metabolic parameters,” read that statement.

“He is intubated and supported by artificial ventilation while the neurological picture remains serious.”

The hospital’s head of neurosurgery, Dr Giuseppe Olivieri, spoke to media later in the day and reiterated the seriousness of Zanardi’s condition.

“The condition of Alex Zanardi is serious but stable,” he said, according to AP.

“He arrived here with major facial cranial trauma, a smashed face, and a deeply fractured frontal bone (forehead). The numbers are good, although it remains a very serious situation.

“We won’t see what his neurological state is until he wakes up — if he wakes up. Serious condition means it’s a situation when someone could die. Improvement takes time in these cases.

“Turns for the worse can be sudden. The operation went according to the plan. It’s the initial situation that was very serious.”

As to a timeline, Dr Olivieri explained, “The next step is to try and stabilise him over the next week or 10 days.

“Then if things go well, he could eventually be woken up and re-evaluated.

“As I told his wife, he’s a patient who is worth being treated.

“As far as a prognosis of how he’ll be tomorrow, in a week or in 15 days, I don’t know. But I’m convinced that he should be treated.”

Zanardi, who has become an accomplished para-athlete since losing both of his legs as a result of a crash in CART in 2001, was competing in the Obiettivo Tricolore relay race in Siena when the incident occurred.