Graft selection and feasibility
In this video, Drs. Lindsay, Pratesi, and Tsilimparis discuss how they approach graft selection in iliac aneurysm repair. They review practical considerations such as anatomical fit, proximal component length, achieving adequate overlap, and ease of cannulation in complex iliac anatomy. These experts also share their own experiences and compare feasibility as they explain what influences their own device choice in everyday endovascular practice.
Transcript
Describe your experience using the ZBIS device.
Thomas Lindsay (00:17)
I think the fact is it’s relatively easy to put in. It’s got the preloaded catheter; it’s got the preloaded wire. So cannulation is not generally an issue. And now when you have fusion imaging, and you know where your internal iliac is at the clock position beforehand, the combination of fusion and the markers allow you pretty clearly to see where your branch is. You can put it in and see clearly before you deploy it.
What differentiates Cook’s ZBIS device form Gore’s IBE device?
Giovanni Pratesi (00:51)
The Gore has larger proximal diameter— is 23 millimeters, is a quite short and fixed length of the proximal component. So if you are treating, for example, angulated or kinking and short proximal iliac limb, sometimes you are not able to have the maximum overlapping between these two components. With ZBIS, you can choose a longer proximal component. So even if you have kink, the proximal common is not an issue for the Cook. Instead, for Gore, it’s very— You can have some issue for the short overlapping.
What do you consider when choosing a graft for a patient?
Nikolaos Tsilimparis (01:36)
It’s very important that we have different options on the market. However, if you would tell me which device I would prefer, I think it’s important to have yourselves a device that is easy to use in most of the cases, and it’s feasible and matches the anatomy in most of the cases. And we did a study a few years ago from our institution in Munich where we evaluated the feasibility of different iliac side branch devices according to the IFU, but also with more liberal criteria based on what we do every day. And we actually saw that the Cook device, the Cook IBD, has a feasibility to use according to IFU in about 50 to 60% of the cases, while the Gore IBE was limited to about 34% of the cases.
All physicians were paid consultants of Cook Medical.