This study states that Endovascular aneurysm repair (EVAR) offers improved short-term survival over open repair (OR), but this advantage may not be sustained long term. The goal of this study was to evaluate outcomes after ruptured abdominal aortic aneurysms (rAAAs) comparing EVAR with OR. This was a single-center retrospective review of a tertiary academic medical center. Data were obtained from the institutional Clinical Research Data Warehouse. All adults who presented between January 1, 2009, and December 31, 2018, with features of rAAA were included. Patients who had rAAA but were treated at an outside hospital and those with ruptured thoracoabdominal aortic aneurysm or ruptured thoracic aortic aneurysm were excluded. Primary outcome was survival. Secondary outcomes were postoperative complications based on the mode of repair.

There were 135 patients with rAAA reviewed. Median age was 75.9 years. AAA position was infrarenal in 102 (76%), juxtarenal in 27 (20%), and suprarenal in 2 (1%). There were 98 patients (73%) who underwent intervention, 64 (47%) EVAR and 34 (25%) OR; 37 (27%) received no operative care. 

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