An abdominal aortic aneurysm is defined as an aneurysmal dilatation of the abdominal aorta, usually increasing in diameter by 50% or more. The vast majority of abdominal aortic aneurysms are lesions below the level of the renal arteries. Other rare causes include cystic degeneration of the middle layer of the artery, syphilis, congenital dysplasia, trauma, infection, and connective tissue disease. Common risk factors include: smoking, hypertension, advanced age, and male. Mortality from ruptured abdominal aortic aneurysms is high. More than 90% of patients with abdominal aortic aneurysms with open rupture of the aneurysm die within a few hours of onset. Treatment of abdominal aortic aneurysms includes pharmacologic, surgical, and endoluminal therapy. Surgical treatment is its main treatment modality, but with advances in materials and techniques for endoluminal treatment, more and more abdominal aortic aneurysms are preferring endoluminal treatment. The prognosis of patients with ruptured abdominal aortic aneurysms varies widely from country to country. Research into treatment differences can help optimize clinical treatment pathways and improve outcomes. Karthikesalingam, MD, PhD, of the Institute of Vascular Research at St. George’s University of London, London, UK, et al. analyzed the treatment modalities and patient prognosis for ruptured abdominal aortic aneurysms in the United States and the United Kingdom, with findings published in the March 2014 issue of The Lacent. The authors compared a nationwide sample of all patients admitted to hospital for abdominal aortic dissection in the UK and US from 2005-2010, with the primary study endpoints being the proportion of patients who died during hospitalization, died after intervention, and had non-corrective treatment decisions. In-hospital mortality and non-corrective treatment rates were counted using binary logistic regression, and data were corrected for age, sex, years of presentation, and Charlson comorbidity index prior to statistical analysis. A total of 11,799 patients with ruptured abdominal aortic aneurysms in the United Kingdom and 23,838 patients with ruptured abdominal aortic aneurysms in the United States were included in the study. The mortality rate during hospitalization was 53.05% in the United States, which was lower than the 65.9% in the United Kingdom. The proportion of people who underwent interventions such as open or endovascular repair was also significantly higher in the United States than in the United Kingdom (80.43% and 58.45%, respectively). The proportion of people undergoing endovascular repair was also higher in the United States than in the United Kingdom, at 20.88% and 8.54%, respectively. Post-intervention mortality rates were similar in both countries, 41.77% in the UK and 41.65% in the US. All of the above observational studies were performed on the basis of age-matched and gender-matched comparisons. In both countries, reduced mortality in patients with ruptured abdominal aortic aneurysms was associated with increased use of endovascular repair, increased number of hospital cases dealing with ruptured abdominal aortic aneurysms, high capacity of hospital beds, level of hospital teaching, and number of patients admitted in a week. Studies have shown that survival rates during hospitalization, intervention rates, and rates of endovascular repair for patients with ruptured abdominal aortic aneurysms are lower in the United Kingdom than in the United States. Both in the UK and the US, a higher proportion of endovascular repairs were performed in teaching hospitals with higher bed capacity and the lowest mortality rates for ruptured abdominal aortic aneurysms. Improved treatment strategies based on these influencing factors may help improve the prognosis of patients with ruptured abdominal aortic aneurysms.