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Objective To compare and analyze the perioperative and early postoperative(30d) outcomes between endovascular aortic repair(EVAR) and open surgical repair (OSR) of Ruptured abdominal aortic aneurysm(RAAA).Methods The clinical data of 71 RAAA patients from April 1999 to December 2013 were collected and analyzed.EVAR (n =12) and OSR (n =59) were performed.Result The patients of EVAR group were older than those of OSR group (68 ± 7 vs 57 ± 11 years old, t =-3.069, P =0.03).The comorbidity rate of chronic obstructive pulmonary disease (COPD) in EVAR group was higher than that in OSR group(58.3% vs 23.7% ,X2 =5.733,P =0.017).As compared with OSR group,the EVAR group had less blood loss (130 ±43 vs 2295 ±425ml,t =-17.529,P <0.001) ,a lower rate of blood transfusion(0 vs 100.0% ,P=X2 =64.058, P < 0.001), shorter ICU stay length, shorter postoperative fasting time, shorter procedure time, and shorter ventilatory support time.The 30 day mortality rate was similar between EVAR group and OSR group(25.0% vs 22.0% ,X2 =0.000,P =1.000).The severe perioperative complication rate was similar between EVAR and OSR group(33.3% VS 32.2% ,X2 =0.111 ,P =0.739).Conclusion Rapid and early diagnosis, urgent surgical repair of RAAA and choosing the appropriate surgical procedures are the keys to reduce the mortality of RAAA.