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Abdominal aortic aneurysms can be repaired using endovascular surgery performed under local anesthesia. However, evidence is sparse concerning how patients experience intraoperative care while being “awake” during major surgery. The primary aims of this retrospective study were to identify patients' perceptions of the quality of intraoperative care during endovascular surgery for aortic aneurysm under local anesthesia and to identify areas for quality improvement. Retrospectively, 26 patients completed the questionnaire “Quality From the Patient's Perspective.” The results showed that 15 of 21 total items received scores above the quality improvement threshold. Patients rated the quality of intraoperative nursing to be very high in terms of how they experienced the situation and nurses' understanding, confidence, commitment, and respect. However, need for improvement was found in four areas: participation, pain, anxiety, and positioning. In conclusion, despite the need for quality improvement in four identified areas, patients undergoing endovascular aneurysm repair under local anesthesia appear to perceive the quality of intraoperative care, especially nursing, as high.