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Iamp;#39;m a Chris Mullin from Cleveland Clinic and moderating this session along with dr. Bacharach and dr. Cummings well go ahead and get started a little bit later here first talk is on my approach to deciding open versus endovascular repair for Triple A these are my disclosures so we we know the options big open surgery versus ivar which we used to do kind of an somewhat smaller incisions but now has kind of converted to this needle poke and band-aid surgery so at first glance you know it seems obvious but I think itamp;#39;s important to remember the aneurysmal disease is progressive in chronic and I think dr. Greenberg used to put this forth during all of his talks it affects the art of wall at different times throughout the patientamp;#39;s life and we really have to plan for the future with this whether itamp;#39;s going to be an open approach and endovascular approach or a hybrid approach this is just another example of a typical infirmary knamp;#39;l stent graft and back
