Arteriography and Abdominal Aortic Aneurysm

To the Editor:—  Helen C. Redman, MD, (208:868, 1969) reported two cases in which calcification of the superior mesenteric artery was erroneously interpreted on the x-ray film as calcification in an abdominal aortic aneurysm. Redman concluded that "arteriography should be performed on all of these patients to confirm the presence of an aneurysm and also to determine its extent." It is our conviction that abdominal aortic aneurysms can nearly always be identified clinically and that aortography is rarely indicated to define their presence or extent.By careful deep palpation with an index finger on either side of the aorta, the actual width of the aorta can be determined in all but the most muscular or obese patients. A tortuous atherosclerotic aorta usually can be identified by physical examination alone. Similarly, careful examination can prevent one from being misled by extraneous vascular calcifications in other abdominal vessels. In a series