What are the long-term outcomes of aneurysm repair?

People are rightly concerned with how you do long-term after aneurysm repair in terms of whether that's open or endovascular keyhole. The chances of having a complication or dying immediately after the operation are much, much lower with an endovascular or keyhole repair. However, with open repairs, particularly at our institution, we have a 0% death rate around the operation for open repair as well because we very carefully assess patients to make sure that they're suitable for open repair. In terms of long term, if you have 10 to 12 years worth of life in you, then there is a clear survival benefit of having an open repair. The reason for that is not entirely clear. It may be related to the fact that the endovascular repair is not as durable, or it may be related to the excess radiation exposure with repeated need for CT scans and angiography as time goes by. So I think the take home message here is that if you have 10 to 12 year life expectancy, then the open repair is indeed the more durable option. The trade-off there is that the perioperative course, the timing around the operation itself can potentially be more challenging for you and for the people looking after you.