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OBJECTIVE The objective of this study was to clarify whether the findings of the randomized studies of repair method (open aortic repair [OAR] vs endovascular aneurysm repair [EVAR]) concerning short-term and midterm survival for ruptured abdominal aortic aneurysms (RAAAs) could be confirmed in a contemporary, nationwide, and unselected population. METHODS This cohort study is based on prospectively collected data from Swedvasc, a nationwide vascular registry, including all 29 hospitals performing surgery for RAAA in Sweden (3 district,