Intracranial Aneurysms in Polycystic Kidney Disease

To the Editor: Levey et al. (April 28 issue)¹ state that their decision-making analysis for patients with polycystic kidney disease was intentionally biased in favor of arteriography and surgery. In fact, a significance value that was used biased the analysis in the opposite direction. The authors' estimate of a 0.37 probability of grave out-come after a ruptured aneurysm is based almost entirely on one article by Sundt and Whisnant.² That article was not intended to look at survival of a cohort of patients with ruptured aneurysms. It is well established that early mortality from ruptured aneurysms is very high. Therefore,.