Endovascular Management of Ruptured Aortic Aneurysms

Aortic Rupture remains a highly morbid condition with all-cause death reaching up to 90% of the cases. For patients who arrive alive in a medical facility, clinical condition of the patient, pre-existing comorbidities as well as institution related characteristics have an impact on the overall prognosis. Centralization of services in centers that can offer both emergency endovascular and open repair along with the implementation of universal organized multidisciplinary team response in case of suspected (Aorta Alert) or diagnosed (Code Aorta) aortic emergency is invaluable to maximize the patients’ survival chances. Increased experience and training in endovascular repair, has established EVAR as the primary treatment option of both intact and ruptured AAAs. EVAR should be offered as a first option in suitable cases of rAAA as it provides a clear survival benefit and about half the perioperative mortality compared to open surgical repair.