Melillo AM, et al. - The morbidity and mortality for ruptured endovascular (rEVAR) and ruptured open (rOPEN) aneurysm repair vs elective endovascular (EVAR) and elective open (OPEN) aneurysm repair were determined. The American College of Surgeons' National Quality Improvement Program database between 2008 and 2016 yielded data of 43,105 AAAs, 34,177 (79.28%) EVARs, and 8928 (20.71%) OPENs. Outcomes suggest that open vs endovascular repair of rAAAs is linked with increased morbidity and mortality. Women vs men exhibited a significant increase in mortality in correlation with undergoing rEVAR. For all rAAAs with hypotension, rOPEN vs rEVAR was associated with increased mortality. A significant increase in lower extremity ischemia was observed with rOPEN and a significant increase in ischemic colitis was observed with rOPEN. Researchers identified great discrepancy between the proportion of rEVAR and rOPEN to EVAR and OPEN. They reported the lagging use of endovascular repair of rAAAs.