The issue of inappropriate treatment with EVAR of patients with AAA size under the 5.5 cm threshold was also addressed.
"In my view... the article's tone is overly harsh in its implication that the 60% of EVAR patients treated with AAAs less than or equal to 5.5 cm were incorrectly managed." He pointed out that Society for Vascular Surgery guidelines specifically indicate that a variety of clinical and/or anatomic features (not to mention patient preference) clearly influence the decision to proceed with treatment "particularly for AAAs in the 5.0-cm to 5.5-cm range."
He also pointed out that larger AAAs are less likely to be anatomically suitable for EVAR.
Dr. Schanzen and his colleagues reported that they had no disclosures.
Dr. Cambria reported receiving research support in the context of participation in clinical trials from W.L. Gore, Cook, and Medtronic.