BackTable / VI / Podcast / Episode #197
CERAB Technique for Aortoiliac Disease
with Dr. Martin Schroeder
Vascular surgeon Dr. Martin Schroeder discusses the Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) technique for treating aortoiliac disease, including patient workup, procedure steps, and pitfalls to avoid with stent placement.
BackTable, LLC (Producer). (2022, April 2). Ep. 197 – CERAB Technique for Aortoiliac Disease [Audio podcast]. Retrieved from https://www.backtable.com
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Dr. Martin Schroeder
Dr. Martin Schroeder is a Vascular and Endovascular Surgeon with Rhein Ruhr University Bochum in Germany.
Dr. Sabeen Dhand
Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.
In this episode, vascular surgeon Dr. Martin Schroeder and our host Dr. Sabeen Dhand discuss the CERAB (Covered Endovascular Reconstruction of Aortic Bifurcation) procedure with all of its steps, including planning, arterial access, recanalization, reconstruction.
First, Dr. Schroeder emphasizes that CERAB is ideal for patients with TASC C and TASC D lesions. For planning purposes, he prefers CT angiogram to MRI, since CT is better at showing calcifications and previous stents. At this stage, he measures the intraluminal area.
Next, he gains percutaneous ultrasound-guided groin access, and he uses a ProGlide preclose system. He takes an endovascular measurement of the aortic diameter and places a covered stent above the aortic bifurcation. Generally, Dr. Schroeder says that it is ideal to stent below the inferior mesenteric artery, but it can be covered if needed. He flares the proximal end of the stent in order to oppose the graft onto the aorta, create a seal, and prevent a Type I endoleak.
Finally, Dr. Schroeder reviews the placement of the iliac stents, the last step in creating a new aortic bifurcation. He shares his 15/15 rule: aortic stent placed 15mm above the aortic bifurcation, and iliac stents placed 15mm within the aortic stent. His general CERAB tips include advancing the sheath before uncovering the stent, making sure that you are always in the intimal space, and staying calm and focused.
Vascupedia CERAB Webinar:
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