“…7 Of particular concern is the scenario in underdeveloped countries, such as Brazil, where physicians may lack access to gold standard equipment, potentially affecting the accuracy of ABI measurements. 8 Given the uncertainty surrounding the reliability of ABI, especially in such contexts, we question the credibility of borderline ABI as a reliable indicator for categorizing the risk of intracranial aneurysms compared to normal ABI, particularly considering the marginal difference between the 2 categories-an aspect not thoroughly explored in the manuscript. 1 Another noteworthy consideration pertains to selection bias.…”