Rosenfeld ES, Macsata RA, Lala S, et al. - In view of the reports describing a decrease operative mortality and morbidity in correlation with undertaking endovascular repair of juxtarenal abdominal aortic aneurysm (JAAA) with fenestrated grafts (FEVAR) vs open surgical repair (OSR), researchers sought to conduct a propensity-matched comparison of OSR and FEVAR for JAAA repair in patients aged ≥ 70. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Targeted EVAR and AAA databases, they retrieved data of patients ≥ 70 years-old undergoing elective non-ruptured JAAA repairs between 2012-2018. Achieving 1:1 propensity-match, they included 136 OSR patients and 136 FEVAR patients in the final analysis. Outcomes suggest no differences in terms of 30-day mortality between open repair of JAAA in the elderly vs FEVAR despite higher pulmonary and renal complications. Although the first line therapy for JAAA in elderly patients should remain FEVAR, OSR may be an acceptable alternative for select patients with anatomy unfavorable for FEVAR.