Abdominal Aortic Aneurysm

To the Editor: Ernst (April 22 issue)¹ provided a comprehensive review of the complex issue of the effectiveness of elective aortic reconstruction for abdominal aortic aneurysms. His presentation, however, was scientifically selective in favor of elective surgery. No physician is in a position to inform patients that they “will require” an operation (particularly an elective one). It is important that physicians make an unbiased presentation of the benefits and risks of this procedure (Table 1). Ernst refers to population-based studies suggesting annual increases in the diameters of aneurysms that were approximately half those reported in referral-center case series (0.2 cm…