Quintana MJ, et al. - Based on discharge data from public hospitals in Spain during 2002–2012, researchers conducted this retrospective longitudinal study to examine variations in the use of open surgical repair (OSR) or endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), a very severe pathology that presents a high risk of mortality in case of rupture, among Spanish hospitals and to evaluate changes in preferences over time for these two procedures. The criteria for patient inclusion were: age >18 years, elective admission, primary diagnosis of unruptured AAA, and surgical treatment with OSR or EVAR. The study sample consisted of 16,737 patients from 114 hospitals [6,809 (40.7%) had EVAR and 9,928 (59.3%) had OSR]. Findings revealed that the variability in the surgical management of AAA repair among Spanish hospitals is high. From 2002 to 2012, the number of AAA repair surgical procedures increased substantially, with EVAR representing a growing proportion of all procedures. Overall in-hospital mortality rates during this period decreased significantly, mainly due to lower mortality rates among OSR patients. In-hospital mortality rates in higher volume centers were lower, irrespective of the surgical approach used.