Published Results of Surgery for Aortoiliac Occlusive Disease

Abstract

Optimal decision making about whether to offer or to undergo any arterial revascularization requires explicit consideration of the risks associated with the natural course of the disease and with specific interventional strategies, as well as the preferences of individual patients concerning specific outcomes. Adequate data are vital to informed decision making. Ideally, one would estimate the likelihood of specific outcomes from the results of prospective population-based studies involving a variety of practice settings and patient types over a broad geographic area. However, with rare exceptions, these data are not presently available for patients with aortoiliac arterial occlusive disease (AIAOD). Instead, practitioners must estimate results from institution-based retrospective studies. The data reported here were collated by use of structured literature review in order to improve decision making for all patients with lower extremity arterial occlusive disease and for their physicians. We accepted the fact of publication bias (for example, the concept that published results would tend to be better than unpublished results), in order to summarize the data physicians are communicating to one another in the literature. These data bring us as close as we can come today to answering the question, ‘‘What can physicians tell patients about the results of reconstructive surgery for aortoiliac arterial occlusive disease, on the basis of available information?’’ The data also focus attention on the related question, ‘‘What additional information do patients and physicians need?’’