title: Emergency EVAR for ruptured abdominal aortic aneurysms: New Zealand experience.
abstract: OBJECTIVE
  A ruptured abdominal aortic aneurysm (rAAA) remains a significant threat to life, with a 30-50% in-hospital mortality rate. The recent introduction of emergency endovascular aneurysm repair (rEVAR) in New Zealand presents an alternative to open repair for rAAAs. The aim of this paper is to review the current experience in New Zealand in the repair of rAAAs.
  
  
  METHODS
  Data from the Australasian Vascular Audit (AVA) was reviewed, with data pertaining to rAAAs collected for the five-year period from January 2010 to December 2014.
  
  
  RESULTS
  Two hundred and eighty-five rAAAs were reported over the five-year period, with an overall mortality rate of 34.0%. There was no significant difference in in-hospital mortality rates alone after rEVAR vs open repair (rOR) (OR 0.39, 95% CI 0.14-1.06, P=0.065). Significant reductions in length of hospital stay (9.710.2 days vs 16.812.9 days, P=0.0125) and the combined in-hospital mortality/post-operative complication rate (35.7% vs 63.6%, OR 0.3, 95% CI 0.1-0.7, P=0.005) were observed after rEVAR vs rOR.
  
  
  CONCLUSIONS
  A primary rEVAR approach is appropriate in selected patients and may represent a paradigm shift in the management of ruptured AAAs in New Zealand.
authors.affiliation: Surgical Registrar, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin.
authors.forename: Sam
authors.initials: S
authors.lastname: Taylor
authors.affiliation: Vascular Surgeon, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin.
authors.forename: Ian
authors.initials: I
authors.lastname: Thomson
authors.affiliation: Vascular Surgeon, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin.
authors.forename: Jo
authors.initials: J
authors.lastname: Krysa
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality* / Q000601:surgery; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D009520:New Zealand; D011183:Postoperative Complications / Q000453:epidemiology*; D018570:Risk Assessment; D016896:Treatment Outcome