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In a 2004 multicenter randomized trial of endovascular versus open repair of abdominal aortic aneurysms (AAAs), researchers in the Netherlands enrolled about 350 patients (mean age, 70; 92% men) with AAAs of at least 5.0 cm. All were eligible for either procedure, and current smoking, hypertension, and hyperlipidemia each were characteristic of at least half of the subjects. In the trial, called DREAM, endovascular repair was found to have marginally significant advantages over open repair in 30-day postoperative mortality and in death or severe complications combined (Journal Watch Cardiology Nov 19 2004). The researchers now report longer-term follow-up (mean, about 21 months).
The endovascular and open repair groups had similar estimated …