Durable by design

In this video, Drs. Tsilimparis, Lee, Modarai, and Branzan share what drives durable outcomes when treating iliac aneurysmal disease. Their observations explore practical issues, including the importance of device integrity and proper sizing and overlap as well as maintaining internal and external iliac artery patency and negotiating tortuous anatomy. The physicians also discuss how a comprehensive aortic portfolio can support procedural consistency when treating complex aortic disease.

Transcript

What is important to you when treating iliac aneurysmal disease?

Nikolaos Tsilimparis (00:13)

What is important is, of course, device integrity and also the patency of the target vessels, which in this case is the internal iliac artery and the external iliac artery. It is very important to have sufficient overlap between the segments to avoid some component separation. And in terms of the long term, it’s important to be able to have the right sizes of stent grafts with the right oversizing in order to have the good patency rates that you need.

What’s needed when treating tortuous diseased iliac arteries?

W. Anthony Lee (00:51)

I think severely diseased and tortuous anatomies pose a challenge in any type of endovascular therapy. In the context of an iliac branch device, I think an operator should have a wide array of ancillary equipment, such as wires, catheters, and even steerable sheaths. But more importantly, in such situations, potentially alternative management techniques, even hypogastric embolization, may be more suitable.

What is your experience with Cook Medical’s comprehensive aortic portfolio?

Bijan Modarai (01:26)

The repairs that we now are able to carry out can involve the entire aortic tree. And Cook has the diversity in stent graft design to allow us to apply these stent grafts to really every territory of the aorta—so from proximal in the aortic arch to distal in the renal and visceral segment, and then finally the ZBIS that allows treatment, preserving the internal iliac artery. And again, as our repairs become more extensive, it’s important to use the whole portfolio for target vessel preservation. And the ZBIS is no different to the other devices in the portfolio when it comes to target vessel preservation.

What is your preference when a company like Cook has a comprehensive product portfolio?

Daniela Branzan (02:18)

When I have the possibility, the anatomical suitability, I go only for one company. There are very seldom cases where this is not feasible. And in that case, you have to really know the products very well and to do a very good planning in order to avoid misalignments and to have also a backup solution in case it does not work. But again, I don’t like to mix components, and that’s why I love the fact that you offer the entire treatment of the thoracoabdominal and aortoiliac aneurysmatical disease.

All physicians were paid consultants of Cook Medical.