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59-64), and 13% were female. The median follow-up time was 401 days (interquartile range, 357-459). Unadjusted 30-day survival was 99.6% overall (open, 99.1%; EVAR, 99.8%; P < .001), with 97.4% 1-year survival overall (open, 97.3%; EVAR, 97.4%; P ¼ .9). Unadjusted reintervention rates were five (open) and seven (EVAR) reinterventions per 100 person-years (P ¼ .8). After propensity weighting, the absolute incidence of perioperative mortality was <1% in both groups (Fig), and complication rates were low. Propensity-weighted survival (hazard ratio, 0.88; 95% confidence interval, 0.56-1.38; P ¼ .6) and reintervention rates (six open and eight EVAR reinterventions per 100 person-years; P ¼ .8) did not differ between the two interventions. The analysis of those younger than 70 years showed similar results.Conclusions: In this study of younger patients undergoing repair of infrarenal AAA, 30-day morbidity and mortality for both open surgery and EVAR are extremely low, and the absolute mortality difference is small. The prior published perioperative mortality benefit of EVAR over open AAA repair is not observed in younger patients. Further studies of long-term durability are needed to guide decision-making for open repair vs EVAR in this population.

Endovascular VAA repairs are increasing. Despite patients' having worse comorbidities and more nonelective admissions, endovascular therapy appears to be associated with decreased mortality and complications and shorter hospital stays.

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