Paul Nicholls, successful earlier with Unioniste, completed an Aintree double courtesy of Rebel Rebellion's game win in the Betfred Grand Sefton Handicap Chase.
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Last year's runner-up Gansey (8/1) looked set to go one place better for much of the contest and was clear jumping the second last only to tread water on the run-in and eventually finish fourth.
The 16/1 winner showed tremendous resolution and having gone to the front before The Elbow held on tenaciously under Ryan Mahon as runner-up Your Busy (33/1) rallied strongly close home.
Half-a-length separated the pair with You Must Know Me (14/1) back in third.
Mahon said: "I maybe got there a little bit too soon but when you have momentum having been outpaced a long way you can't afford to sit and wait. He jumps serious, you couldn't get one better."
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- Aintree and Sandown
Assistant trainer Tom Jonasson said: "First tine out this season we thought he would need the run and he ended up running behind Sire De Grugy which looks good form now.
"He ran better at Sandown last time, and obviously came on for the run again. He jumped like a buck and the cheekpieces did the trick on the run-in. This was the target and I wouldn't know where he'd go now."
There was one fatality with Plein Pouvoir having to be put down following a fall in which he suffered a fractured right elbow.