Treatment of ruptured abdominal aortic aneurysms in the endovascular-first era

Ruptured abdominal aortic aneurysms (RAAAs) are fatal in the majority of cases, and mortality remains high in patients who survive to undergo surgical repair.1 Most patients with an RAAA arrive to the hospital with limited physiologic reserve, and thus it is not surprising that less invasive procedures such as endovascular aneurysm repair (EVAR) are increasingly used to treat this condition. The enthusiasm for EVAR over open repair has been...