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Despite early advantages, endovascular repair of abdominal aortic aneurysm (AAA) doesn't reduce mortality compared with open surgery long term, a randomized trial showed.

The lower perioperative mortality risk seen with the less invasive method persisted at 3 years, with a 28% reduced risk of all-cause mortality, Frank Lederle, MD,of the VA Medical Center in Minneapolis, and colleagues found.

But the difference disappeared after that point to reach an almost identical all-cause mortality risk (hazard ratio 0.97, P=0.81) through up to 9 years of follow-up in the Open versus Endovascular Repair Trial (OVER).

Notably, the older patient group expected to gain the most from endovascular repair actually tended to have better survival rates with open repair, Lederle's group reported in the Nov. 22 issue of the New England Journal of Medicine.

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