EVAR for Ruptured Abdominal Aortic Aneurysms

R uptured abdominal aortic aneurysms (rAAAs) are being treated by endovascular aneurysm repair (EVAR) and other endovascular techniques with increasing frequency. Endovascular procedures offer many potential advantages over open repair (OR); they are less invasive, eliminate damage to periaortic and abdominal structures, decrease bleeding from surgical dissection, minimize hypothermia, and lessen the requirement for deep anesthesia. Because of these advantages, EVAR has been used extensively to treat rAAAs by several groups who have achieved good results.1-8 In contrast, some other groups have been unable to demonstrate the superiority of EVAR over OR in the rAAA setting.9,10 This article describes some of the strategies, techniques, and adjuncts that facilitate the endovascular treatment of rAAAs. We believe that these all contribute to improved outcomes in terms of enhanced survival rates in a group of patients that is difficult to treat.