• EVAR-1 Trial:  1082 fit patients with AAA suitable for either open repair or EVAR; 30-day mortality was 4.7% versus 1.7% respectively, although there was a higher rate of late complications (mainly stent related) with EVAR. Although aneurysm-related mortality was slightly lower in the EVAR group, over time, all-cause mortality was no different.
  
• EVAR-2 Trial:  338 medically unfit patients with AAA who were suitable for either open repair or EVAR but not fit for open repair. The patients were therefore randomised between EVAR and BMT. There was no difference in mortality between the groups. See Chapter 66 for more on these.

Elective versus Rupture

An elective repair should generally be planned when the AAA is larger than 5.5 cm with a CT aortogram to assess the morphological suitability for EVAR. The patient should also be assessed for physiological fitness with the usual preoperative tests but also assessment of cardiac and respiratory function with investigations such as:

• cardiopulmonary exercise testing (CPEX)
  
• echocardiogram
  
• lung function tests.

In the ruptured

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