Elective Arterial Reconstruction for Intermittent Claudication is Justified

This study evaluates the appropriateness of performing arterial reconstruc tion in patients with intermittent claudication due to arteriosclerosis obliterans. Among 163 symptomatic patients, 175 limbs in 130 patients underwent surgical revascularization as the primary mode of therapy. There were 3 operative deaths and 21 late deaths after an average of 3.5 years of follow-up. The most common cause of death was heart failure, including ischemic heart disease. The five-year cumulative patency rate was 92.5% for aortoiliac, 70.6% for femorodistal, and 82.0% for aortofemorodistal reconstructions. The long-term symptom free rate was 87.3% for aortoiliac, 57.7% for femorodistal, and 86.7% for aorto femorodistal reconstructions. The authors conclude that intermittent claudication is an appropriate indi cation for surgery in patients with lower extremity ischemia to enhance the quality of life, except in patients with serious concomitant medical illness.