Access Type for Endovascular Repair in Ruptured Abdominal Aortic Aneurysms does not Affect Major Morbidity or Mortality

Abstract Objective There is limited data on access type when treating ruptured abdominal aortic aneurysms (AAA) with EVAR. Our study’s objective was to evaluate if the type of access in ruptured abdominal aortic aneurysm affected outcomes. Methods The Vascular Quality Initiative was queried from 2009 to 2018 for all ruptured AAA treated with an index EVAR. Procedures were grouped by access type: percutaneous, open, and failed percutaneous that converted to open access. Patients with iliac access, both percutaneous and open access, and concurrent bypass were excluded. Baseline characteristics, procedure details, and outcomes were collected. Univariable and multivariable analyses were performed. Results There were 1,206 ruptured AAAs identified - 739 (61.3%) was performed by percutaneous access, 416 (34.5%) by open access, and 51 (4.2%) by failed percutaneous that converted to open access. Percutaneous access, compared to open access and failed percutaneous access, respectively, had the shortest operative time (mins, median) (111 vs. 138 vs. 180, P Conclusions Access type for ruptured AAA was not independently associated with major morbidity or mortality but did have a differential effect on length of stay. Access during these emergent procedures should be based on surgeon preference and experience.