SURGICAL advice for patients with aortoiliac occlusive disease is complicated by the fact that indications for operation may be based solely on a degree of decreased exercise tolerance. Some authors have referred to such an indication as economically disabling intermittent claudication or claudication producing occupational handicap.1,2 We agree with the rationale of relating the need for operation to economic survival; but we also have faced an intense desire for improved exercise tolerance for other than economic reasons by members of this affluent society, which is presumed to move almost exclusively on wheels. For example, to many patients an impaired exercise tolerance as related to leisure-time activities is unacceptable and justifies taking reasonable surgical risks to obtain relief. This has stimulated us to seek more precise knowledge of the factors that contribute to the risks of such surgery.
In our series as well as in those of others, patients with