Technical tips for EVAR for ruptured AAA.

Endovascular treatment of ruptured abdominal aortic aneurysms is associated with decreased morbidity and mortality when compared to the open surgical approach, yet, there are several fundamental obstacles to our ability to offer these endovascular techniques to many patients with ruptured aneurysms. This article will focus on the technical aspects of endovascular aneurysm repair for rupture aneurysms, with particular attention on developing a standardized multidisciplinary approach that will address some practical issues, such as the need for preoperative computed tomography, choice of anesthesia, percutaneous access versus surgical exposure of the femoral arteries, use of aortic occlusion balloons, bifurcated versus aorto-uniiliac stent grafts, adjunctive procedures, diagnosis and treatment of abdominal compartment syndrome, and conversion to open surgical repair.