Dr. Peter Soden recently became one of the first surgeons to implement the Zenith Iliac Branch Device, or the ZBIS device, at Rhode Island Hospital, marking a new way to treat patients with aortoiliac and iliac aneurysms. Soden recently spoke with Providence Business News about the procedure and the ZBIS device.
PBN: How does the ZBIS device differ from other treatments for aneurysms?
SODEN: There are two commercially available iliac branched stent grafts – including ZBIS – that treat iliac aneurysms while maintaining blood flow into the internal iliac artery in the pelvis.
Outside of using these two branched devices, the options historically were to shut down the internal iliac artery and stent across its opening or perform an open repair, which has higher peri-operative risk for the patient.
PBN: Are there any risks for patients associated with using the ZBIS device?
SODEN: With a good operative plan, risks should be low and are no different than other minimally invasive stent graft devices for treating aortic and aortoiliac aneurysms. The surgeon must select the right operation for the right patient with the right device.
In general, risks include bleeding, improper seal of stent, a need for further interventions, unintentional occlusion of an artery, stress on the heart, and injury to the kidneys.
PBN: Why is it important to preserve blood flow when treating aneurysms?
SODEN: Before iliac branched endovascular stents like ZBIS, the internal iliac perfusion was shut down when an iliac aneurysm was treated, which would dramatically reduce blood flow to the pelvis and would complicate future minimally invasive operations for aneurysm repair.
In addition, shutting down the pelvic artery could lead to significant buttock pain when walking and inadequate blood supply to parts of the colon, which can be a surgical emergency. By preserving blood flow through the internal iliac artery, pelvic perfusion is maintained while eliminating risk of rupture from the aneurysm itself.
PBN: Who is eligible to get this procedure?
SODEN: Most patients with iliac or concurrent iliac and abdominal aortic aneurysms are eligible. There are a few anatomic reasons patients would not be eligible and would require an open repair. These anatomic restraints can be easily identified on a CT scan, which would be done to fully evaluate the aneurysm.
PBN: What is recovery like with this procedure compared with other ways for treating aneurysms?
SODEN: Compared to an open repair, patients can expect to leave the hospital sooner and are less likely to have complications from that initial hospitalization. On average, patients after minimally invasive endovascular repair of aneurysms, like ZBIS, leave one to two days after their operation compared to seven to 10 days after open repair.
Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com.
