Davis FM, et al. - Researchers examined how management of abdominal aortic aneurysm (AAA) varied with respect to diameter. Further, they investigated the physician's rationale for intervention on small AAAs in relation to recommended treatment guidelines. Performing a retrospective review of a statewide vascular surgery registry of all elective endovascular or open surgical AAA repairs from January 2012 to January 2016, they identified 3932 patients who underwent an elective AAA repair. In 485 (12.3%), the repair was done at diameters smaller than recommended by guidelines. Findings suggest the existence of marked variation both at the hospital level and in terms of the physician's rationale for the management of elective AAA repairs despite well-established aortic diameter threshold guidelines. This highlights the difficulty of implementing uniform care for these patients despite established guidelines.