Ziehm Newsletter

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Success through Partnership

Winter 2024

2024 Commercial Summary
• Record Sales in Q1 •

Mobile C-Arms:

  • Sales have continued their growth trajectory, achieving a record figure in Q1.
  • This success is due to diligent work with both new and existing customers, as well as maintaining stock for last-minute inquiries.
  • Orders were received from twenty different sites in 2024, including 3 from Preston Royal and 8 from Greater Glasgow Trust.
  • The UK C-Arm market is projected to remain around 200 units, consistent with 2023 but significantly below the post-COVID peak of 245 in 2021.

Mini C-Arms:

  • Sales have faced challenges in recovering after delays from Orthoscan MDR certification.
  • Competitive pricing against GE and Hologic has resulted in minimal margins.
  • Product Manager Simon Brickell, who was on sick leave for six months (March to September), has returned and is making a positive impact.

Rental:

  • Xograph’s rental business remains robust, having more than doubled in size since 2019.
  • The strategy of renting nearly new equipment, particularly C-Arms, continues to generate revenue.

Therenva:

  • Basildon is successfully using the EndoNaut they are renting, achieving self-sufficiency after initial support.
  • A potential second sale is pending at Cardiff, awaiting budget approval after a business case was created.
  • With Product Manager Warren Gibbard’s departure, new Applications Specialist Luke Whitworth’s training is being expedited, with plans to train additional staff.
  • Efforts are underway to generate more leads by partnering with a stent provider.
  • The VSASM exhibition in Brighton at the end of November will feature the EndoNaut, likely generating valuable leads.

Driving Innovation: Expanding the Reach of Ziehm Vision RFD 3D in Partnership with Stryker

Expanding the Ziehm Vision RFD 3D Install Base
This year has seen remarkable achievements in our collaboration with third-party implant vendors, resulting in a significant increase in the Ziehm Vision RFD 3D install base. Xograph Healthcare is committed to further expanding this success by strengthening these valuable partnerships.

Strengthening Collaborations
To ensure continued growth, Xograph Healthcare plans to host in-house training sessions with senior staff from Stryker. These sessions aim to deepen understanding and enhance the skills needed to promote the Ziehm RFD 3D system effectively.

Empowering Through Education
A joint workshop is being organised to educate and empower sales teams about the benefits of the Ziehm RFD 3D system, positioning it as the ideal mobile imaging solution for spinal navigation. This workshop will include hands-on integration and joint calibration of the spinal navigation system with the RFD 3D, reinforcing current knowledge and fostering stronger relationships among sales teams, clinical applications personnel, and engineers.

Innovative Promotion Methods
We are also exploring innovative ways to promote the Ziehm RFD 3D, such as cadaver workshops in collaboration with navigation partners. A recent event with Brainlab, initiated by Consultant Neurosurgeon and Spinal Surgeon Mr. Marcel Ivanov from Sheffield, highlighted the system’s capabilities. Mr. Ivanov shared his positive feedback:

“Dear Peter, thank you very much for your help with the course last week! It worked very well and allowed us to use navigation while others could appreciate the great quality of Ziehm!”

By continuing to build on these efforts, we aim to further enhance our presence and impact in the UK market.

Therenva EndoNaut goes live in Basildon!

My experience; the Endosize and Endonaut systems are intuitive and easy to use. I have used the system for the full range of aortic procedures; thoracic, thoraco-abdominal, simple and complex abdominal procedures, its proven to be accurate and the ease with which I can manipulate and highlight areas of interest intra-procedurally has led to reduced radiation, operating times and very accurate stent placement.

Mr Vijay Gadhvi
Consultant Vascular Surgeon 

Endonaut and Endosize have transformed our practice. Not only have we documented reduced radiation exposure and contrast needs, we now increasingly notice shorter times to implantation of EVAR and FEVAR grafts.  

There is an added benefit of using Endonaut in conjunction with be back catheters to re-canalise  shuttered or inadvertent occlusion of target vessels. Therenva have been very wise to twin the two software programs together with a full library of Endovascular  devices to plan procedures.

Mr Tom Browne
Consultant Vascular Surgeon

10 C-arms for Cardiff!

Cardiff and Vale University Health Board is one of seven NHS Health Boards across Wales and hosts the University Hospital of Wales (UHW), the largest hospital in Wales, located in Cardiff.

As expected for such a large hospital, UHW covers a wide range of specialties, including Cardiology, Urology, Cardiothoracic Surgery, Trauma and Orthopaedics, Pain Management, and Paediatric Surgery.

Over the past few years, UHW has purchased several Ziehm C-arms from Xograph and now owns ten systems in total. These include five Vision FD C-arms, three Vision RFD 21x21cm, one Vision RFD 31x31cm, and a Vision II. The systems are used almost daily across multiple theatres due to the demands on each service within the hospital.

When speaking to the radiographers about their experience with the Ziehm C-arms, several team members commented that the interface is intuitive and easy to use. They particularly appreciate that the interface is consistent across all system specifications, allowing them to confidently operate any system in any theatre.

The Theatre Lead radiographers noted that across various disciplines, surgeons have praised the high standard of image quality, while the radiographers themselves highlighted that this quality is achieved while maintaining appropriate dose levels. They also reiterated the ease of use due to the common interface functions, which allows for more efficient training—UHW typically has an intake of 12-20 newly-qualified radiographers each summer.

The University Hospital of Llandough, also under the same Health Board as UHW, has three Ziehm systems on site, comprising a Vision II and two Ziehm Vision FD C-arms, bringing the total to thirteen Ziehm systems across Cardiff and Vale Health Board.

We hope to continue working with the teams across both sites to ensure they get the best from their Ziehm C-arms by providing an exceptional standard of support, in terms of technical service and ongoing Clinical Applications training.

Meet the Team

Peter Drozd

Role: Clinical Product Manager (Surgical Imaging)
Background: Born in West Yorkshire
Years with Xograph – Nearly 20 happy years
Job Satisfaction: Enjoys making a difference in his work
Personal Pride: Proud of his partner, Elizabeth, and his family
Career Highlight: Winning Sales Person of the Year two consecutive years
Favourite Saying: “While we try to teach our children all about life, our children teach us what life is all about.”
Holiday Destination: Icmeler, Turkey—loves the heat
Favourite Cuisine: Enjoys a very hot Chicken Phall curry
Passions: Dedicated to his work
Relaxation: Unwinds by checking emails
Humour: Finds humour in looking in the mirror
Favourite Personalities: Michael Schumacher (German) and Timo Ihamäki (Finn)

Fun Quiz:
Halloween + Old Face + Grandchildren + Face paint kit = ?

Discovering Excellence at Ziehm's Nuremberg Facility

The Xograph team enjoyed exceptional hospitality in Nuremberg, along with an impressive tour of Ziehm’s world-class facility and a very productive business meeting. We look forward to bringing customers to Nuremberg to showcase what sets Ziehm apart from the competition, hopefully starting with the physicists’ training course in 2025.

Not even the delayed 6:30 AM Ryanair flight could take the shine off an outstanding visit, thanks to all the team at Ziehm!

Strengthening Partnerships: Collaborating with Mid and South Essex NHS Foundation Trust

Building a Collaborative Relationship
We are thrilled to share the progress of our strong partnership with the Mid and South Essex NHS Foundation Trust, anchored in trust, excellent communication, and unwavering support.

Engagement Overview
The Trust encompasses several key hospitals northeast of London, where our collaboration has been pivotal in providing advanced imaging solutions.

  • Southend University Hospital: Enhanced its imaging capabilities in 2022 by acquiring two Ziehm Vision FD C-arms.
  • Basildon Hospital: Invested in four Ziehm Vision FDs last year, with discussions underway for an additional unit to support a new service planned for 2025, showcasing their commitment to cutting-edge technology.
  • Orsett Hospital: Acquired one Ziehm Vision FD last year, alongside Basildon’s expansion.
  • Broomfield Hospital: Currently discussing a business case to replace two existing units in 2025, underscoring our ongoing support for their imaging needs.

Maintaining a Strong Relationship
Our successful partnership with the Trust is supported by several key strategies:

  • Effective Communication: We prioritise open dialogue with all stakeholders to understand their needs and respond promptly to any concerns.
  • Training and Support: We collaborate with department managers to ensure high training levels for radiographers and work with the Trust’s EBME department to provide first-line support training, minimising equipment downtime.
  • Building Rapport: We have cultivated strong relationships with key financial decision-makers, facilitating smooth negotiations and alignment with the Trust’s goals.

Through these efforts, Xograph is dedicated to supporting the Mid and South Essex NHS Foundation Trust in delivering exceptional healthcare services.

Events

Vascular Society Annual Scientific meeting,
Brighton – November

Peter Drozd, Adam Hocking & Bart Hoff, focusing on Therenva

British Orthopaedic Association,
ICC Birmingham – September

Simon Brickell Product Manager, promoting Orthoscan

UK Imaging and Oncology,
ACC Liverpool – June

The Xograph team

Enhanced Support for Ziehm Customers

Xograph have successfully established over 50 high-level Ziehm contracts with end-user clients. Our customers are rightly demanding focused attention that is considerate and empathetic towards their unique set of requirements. Our navigation vendor partners are also demanding dedicated resources to support their client business proposition(s) (both pre-sales and post-sales).

Following a business review on the growing Ziehm portfolio, it was decided that we needed a dedicated Service Support Manager to cater for the demanding needs of our customers. The aim was to present a comprehensive one-stop-shop which will add continuous and tangible value to all stakeholders. The net business reward from the successful implementation will be year-on-year growth of new high-end Ziehm C-arm solutions and enthusiastic client uptake and renewal of our enhanced contract offering.

The new incumbent for this role is our very own Adrian Chadbourn, a manager who has come up through the ranks of Xograph. Starting as an engineer, he later became Ziehm Product Specialist and is the fount of knowledge on Ziehm systems. With Adrian’s technical knowledge, he has already proven his background and has assisted our customers with high-level escalations and equipment repair management in a very precise and professional manner.

Adrian is a great asset within the company, helping the business grow with our Ziehm products.

Adrian Chadbourn (Right)

1st 3D Spinal Case at Port Talbot Hospital

Neath Port Talbot Hospital is a 270 bed general hospital located in Port Talbot, South Wales. It is one of a number of several hospitals under the Swansea Bay University Health Board.

The Ziehm Vision RFD 3D was purchased in 2022 prior to a £21M projected expansion which included three new theatres.

Hospital expansion completion occurred in 2023 and following much deliberation by site regarding choice of navigation vendor, Medtronic was finally chosen.

Integration of the RFD 3D with Medtronic’s Stealth Station S8 occurred this year.

The first 3D navigation spinal case was performed 4th November with successful navigation of pedicle screws using (MIS ) Minimal Invasive Surgery technique ( reducing the requirement to surgically cut the patient’s tissues as much as would have been expected using non MIS surgical methods.)


Shaun Davis (Left), Alys China (Right)

Lead Radiographer, Alys China who operated the RFD 3D voiced that the use of the unit was straight forward and uncomplicated following the in depth training received once navigation integration had occurred.