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Cook’s Zenith Branch Iliac Endovascular Graft passes treatment milestone

Cook : 22 August, 2008  (Company News)
Cook Medical’s Zenith Branch Iliac Endovascular Graft has passed major landmark for advanced interventional technology to treat aortic disease by being used to treat the world's 1,000th patient undergoing endovascular treatment for an aorto-iliac or iliac aneurysm.
Ferdinand Serracino-Inglott, one of only 200 vascular surgeons performing this type of surgery in Europe, carried out the minimally invasive endovascular procedure at Manchester Royal Infirmary. The stent-graft used in this procedure was manufactured by Cook Medical, the global leader in endovascular therapy products for aortic aneurysms and dissections.

The 1,000th patient, James Chambers, had an infra-renal aortic aneurysm extending to involve his right iliac artery (the blood vessel that extends from his tummy to his groin). He underwent an elective endovascular procedure earlier this year. Following the procedure, Chambers made a quick and uneventful recovery.

Serracino-Inglott explained: “Abdominal aortic aneurysms sometimes extend to involve the iliac arteries. With traditional stent-grafts, treating such aneurysms involves blocking off the blood supply to the buttocks, pelvis and genital organs. This may lead to impotence and severe buttock pain on walking. Cook's advanced endovascular technology to preserve blood flow to the internal iliac artery, however, allows placement of the advanced stent-graft while retaining crucial blood flow, lessening the risk of those complications. The company manufactures two versions of the endograft, the Zenith Helical Graft and the Zenith Branch Iliac Graft, for use depending on patient anatomy.”

Dr Serracino-Inglott said: “Cook Medical's Zenith endovascular Graft technology is unique in that it is the only technology currently available that allows a surgeon to repair an aorto-iliac aneurysm, whilst still maintaining a good flow of blood to these arteries, thereby preventing these problems.”

A stent-graft is a tubular structure composed of two elements. The Stent is a self-expanding mesh-like structure made of metal (such as stainless steel). Its function is to provide support to the graft. The latter is composed of a special fabric that is impervious to blood and lines the stent. The Stent Graft is packed in small diameter tubes called catheters.

Endovascular surgeons like Serracino-Inglott use Stent grafts to treat aortic aneurysms. They advance the Stent Graft upwards, through small incisions in the arteries at the groin, under X-ray guidance, to precisely place the device within the aorta. Once released from the catheter, the Stent Graft lines the aortic aneurysm from within. Once the Stent Graft is in place, blood flows through the opened Stent Graft as opposed to through the aneurysm, thereby reducing the risk of rupture.

The procedure of treating aortic aneurysms with Stent grafts is known as EVAR. This stands for endovascular aneurysm repair. This is not the only method for treating aneurysms; there is also the longstanding method of open surgical repair.

However some members of the medical community remain divided on the best method of treatment, Serracino-Inglott explained: “Unfortunately there are still a large number of surgeons who exclusively perform open surgery for these conditions, when in my opinion minimally invasive endovascular treatments are far superior. As such I think that endovascular surgery should be the primary method of repair for all aneurysm cases with open surgery being reserved for those patients in whom EVAR is technically not possible. The case for EVAR is strong and I would encourage the medical community to think of EVAR as the new gold standard of repair.”
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