Please select the eligibility criteria that correspond to the clinical trial below.
Title: CSP #498 - Open Versus Endovascular Repair (OVER) Trial for Abdominal Aortic Aneurysms
Brief Summary: A multi-center, randomized clinical trial that will compare endovascular repair with standard open surgery in the repair of abdominal aortic aneurysms (AAA). Long and short-term results as well as the cost and quality of life associated with these two strategies for AAA repair will be compared.


Options:
A: Inclusion Criteria:

* Age \>= 18 years
* Ruptured aorta-iliac aneurysms diagnosed by CT
* scan with injection.
* Aneurysm developed on native infra-renal aorta or iliac.

  * Non infectious false aneurysms developed on prosthesis (Deleted by amendment n°1 at the request of AFSSAPS)
  * Ruptured aneurysm after endoprosthesis (Deleted by amendment n°1 at the request of AFSSAPS)
* Stable hemodynamic condition: systolic blood pressure on arrival higher than 80 mmHg in the absence of continuous vasopressive drugs administration.
* Anatomic criteria :length of aortic proximal neck \>10 mm, diameter of aortic proximal neck \< 32 mm, Absence of aortic neck angulation \> 90° and patent iliac without important stenosis or tortuosity.
* Technical constraints (validation of experience form) : Trained operator (at least 15 endoprosthesis in asymptomatic patients), Endovascular materials at disposal

Exclusion Criteria:

* Unstable hemodynamic condition
* Anatomic criteria of non-inclusion
* Asymptomatic aneurysm
* Non-ruptured symptomatic aneurysm or aneurysm complicated with emboli.
* Mycotic aneurysm, infectious false aneurysms
* Post-traumatic aneurysm
* Supra-renal thoracic-abdominal aneurysm
* Impossibility to obtain a CT-scan with injection
* Patient non-affiliated to the social security and the protected people
* Pregnancy or breast-feeding
B: Inclusion Criteria:

* Patients of 50-80 years of age
* Non symptomatic infrarenal AAA of 4.1 to 5.4 cm in diameter measured by CT performed within 3 months before randomization
* Adequate infrarenal aortic neck (length \> 15 mm diameter \< 30 mm) and other anatomical configurations suitable for EVAR
* Patients have a life expectancy of at least 5 years
* Signed informed consent

Exclusion Criteria:

* Ruptured or symptomatic AAA
* AAA maximum diameter \>= 5.5 cm
* Suprarenal or thoracic aorta aneurysm of more than 4.0 cm
* Patient unsuitable for administration of contrast agent
* Severe heart, lung, liver or renal disease (serum creatinine \>= 3mg/dl)
* Need for adjunctive major surgical or vascular procedures within 1 month
* High likelihood of non compliance with follow-up requirements
C: Inclusion Criteria:

* Patients aged 50 years old or more (more than 80 possible depending on physiological age)
* Level 0, 1, or 2 of operative risk
* Abdominal aortic aneurysm with a diameter \> or equal to 50 mm or \> or equal to 40 mm if rapid growing (10 mm or more in a year), or painful, or saccular aneurysms, or aneurisms of common iliac arteries with a diameter equal or superior to 30 mm; or women with a diameter equal to 45 mm;
* Aortic neck superior or equal to 1.5 cm
* No stenosis superior or equal to 75% of the superior mesenteric artery
* Proximal neck angulation inferior to 80°
* Diameter of the iliac arteries compatible with introducer sheath
* Inform consent signed

Exclusion Criteria:

* Aneurysm involving the renal arteries or with the length of the neck less than 1.5 cm
* Thrombus or major calcification in the neck
* Diameter of the iliac arteries not compatible with introducer sheath
* Level 3 of operative risk
* History of major iodine allergy (Quincke oedema, anaphylactic shock)
* Other comorbidity with life expectancy less than 6 months
* Follow up impossible during the trial
* Participation in another trial
* Inform consent not signed
D: Inclusion Criteria:

* AAA with a maximum external diameter in any plane greater than or equal to 5 cm.
* An iliac aneurysm (associated with an AAA) with a maximum external diameter in any plane greater than or equal to 3 cm.
* AAA greater than or equal to 4.5 cm and the AAA has increased by greater than or equal to 0.7 cm in diameter in 6 months.
* An AAA greater than or equal to 4.5 cm and the AAA has increased by greater than or equal to 1 cm in diameter in 12 months.
* An AAA greater than or equal to 4.5 cm and the AAA is saccular (i.e., a portion of the circumference of the aorta at the level of the aneurysm is considered normal based on CT scan or MRI).
* An AAA greater than or equal to 4.5 cm and the AAA is associated with distal embolism.

  * as measured from two imaging studies (ultrasound CT scan or MRI) within the appropriate interval, the later one within 6 months of randomization.

Exclusion Criteria:

* Patient has had a previous AAA repair procedure
* Evidence of AAA rupture by imaging test
* AAA is not elective (i.e., urgent or emergent operation, usually due to suspected rupture)
* Likelihood of poor compliance to the protocol
* Patient refused randomization
* Physician refused randomization

Answer: D