What are the treatment options for an aneurysm?

what are the treatment options for an aneurysm? So effectively what one has to do is prevent blood going through the weakened wall because the main risk of an aneurysm in particularly an aortic position we're talking about now is that that weakened wall at some stage will leak, the aneurysm will rupture and blood will leak out of that wrench in the wall and that is associated with about an 80% mortality in a vast majority of patients. So trying to prevent blood pressurizing the aneurysmal sac is the main game and up until sort of mid-1990s the only way of doing this was open surgery and that was a laparotomy to open abdomen to dissect the aneurysm above and below the weakness, clamp above and below, open the aneurysm and then sew in a polyester dacron or cortex tube, a man-made tube to replace the aorta, the blood goes through that rather than through the aneurysm. What has happened more recently is an endovascular approach, so this is a more minimally invasive approach which goes inside the artery, usually from the femoral arteries in the groin and a stent graft is passed in. A stent graft is again either a cortex or a polyester tube which has been cinched on to a very small delivery device and that is supported by a metal framework and as that is positioned within the body under x-ray guidance, it is deployed by allowing it to expand and get a seal above and below the aneurysm. So stent grafts are, some patients are suitable for them, the anatomy has to be ideal to get a seal above and below. What we perhaps don't understand quite as much is how durable they are. We have pushed the boundaries of possibilities for stent grafts over the last 10 years and we now know that some of those aren't as durable as we'd hoped. So we looking at the anatomy and choosing people who are best suited to stent grafts is likely to improve durability. The problem is then that the other group of patients can only probably have open surgery, which is perhaps more durable but up front the chance of getting through an operation and recovering is much slower with open surgery.