The objective of this study was to clarify whether the findings of the randomized studies of repair method (open aortic repair [OAR] vs endovascular aneurysm repair [EVAR]) concerning short-term and midterm survival for ruptured abdominal aortic aneurysms (RAAAs) could be confirmed in a contemporary, nationwide, and unselected population.

This cohort study is based on prospectively collected data from Swedvasc, a nationwide vascular registry, including all 29 hospitals performing surgery for RAAA in Sweden (3 district, 19 county, and 7 university hospitals) during 2013 to 2015. All 702 patients operated on for RAAA during this time were included. Open surgery and endovascular repair, analyzed on the basis of individual patient repair (OAR vs EVAR) and hospital repair practice (OAR-only vs OAR/EVAR), were compared for short-term and midterm adjusted survival (0-90 days and 3 months-3 years).

Endovascular repair was used for 37% (260/702) of the aneurysms. The adjusted hazard ratio after OAR was 1.30.

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