The limitations the authors pointed out were those inherent to a retrospective study with a relatively small sample size. In addition, there might have been a selection bias on the choice of treatment rendered. Propensity score–based matching can only remove overt bias; unlike randomization, it cannot remove hidden biases.
"There is still equipoise on what the best treatment for ruptured AAA is. The data [in the literature] are conflicting, and many studies showing improved outcomes with REVAR employed it preferentially for patients with favorable anatomy and hemodynamic stability. Preferential REVAR should be deferred until results of prospective, randomized trials are available and predictive factors for its success are identified. Some patients may be harmed by indiscriminate insistence on REVAR," Dr. Cho and his colleagues concluded.
The authors reported that they had no conflicts of interest with regard to their paper.