You lust and use CDs and you're set. That's how we did VotW+10 last week on EU.
But yeah, in combination with Raging and/or Necrotic it's obviously a bitch. I was talking specifically about the combo those guys had (Sanguine/Overflowing). I'd very much prefer Fortified over Tyrannical for that combo (although I guess Fortified is worse on a "time spent" basis).