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Erik Buskens, MD, PhD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Timaran and others¹ report on what essentially appears to be a registry-based observational study and go at length to explain why their results may be used to refute the results of the EVAR (endovascular aortic aneurysm repair) 2 trial.² They recognize the fact that by definition their design is inferior but still claim that no patients should be denied "rescue" by a vascular surgeon. Interestingly, framing the message as denying care instead of what more appropriately may be called offering optimal medical care already sets the scene.

However, the pivotal problem that can never be resolved, even if the study represented the experience of the entire world, is what would have happened had these patients not been offered EVAR. The latter notion seems beyond the authors' conception. The fact is that the authors simply do not provide a satisfactory explanation for the huge difference in complication . . . [Full Text of this Article]

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RELATED ARTICLE

Endovascular Aortic Aneurysm Repair in Patients With the Highest Risk and In-Hospital Mortality in the United States
Carlos H. Timaran, Frank J. Veith, Eric B. Rosero, J. Gregory Modrall, Frank R. Arko, G. Patrick Clagett, and R. James Valentine
Arch Surg. 2007;142(6):520-525.
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Denying May Yet Make Sense—Reply
Carlos H. Timaran
Arch Surg. 2008;143(2):209.
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