The "Elephant Trunk" technique made easier

Gelweave™ Siena graft for aortic arch and first stage "Elephant Trunk" procedures

The "Elephant Trunk" Technique has been shown to greatly facilitate and reduce the risk of multiple-stage aortic replacement1

The Gelweave™ Siena graft used in a modified "Elephant Trunk" technique, was conceived to overcome the difficulties and the risks inherent in a large aneurysmal neck1.

Aortic Arch Plexus facilitates individual arch vessel reconstruction2

GelweaveTM  technology with excellent handling3

Radiopaque markers facilitate 2nd stage repair1

GelweaveTM Siena - Two stage hybrid Elephant Trunk Procedure


This film demonstrates GelweaveTM Siena being used for a first stage surgical procedure and a separate stent being used for second stage endovascular completion. Please note: Stent is not included with the GelweaveTM Siena graft. 

Professor Eugenio Neri, Dr Enrico Tucci, Dr Muzzi Luigi, Dr Antonio Benvenuti, Dr Giulio Tommasimo - Italy

Dr Cameron Ricci, Dr Marco Cini, Dr Francesco Vigini - Italy

Key Features of GelweaveTM Siena

Aortic Arch Plexus

Facilitates individual arch vessel reconstruction2

Ante-Flo Side Branch

Enables lower body reperfusion and earlier patient re-warming4

Radiopaque Markers

Radiopaque tantalum markers are located at strategic points along the length of the Gelweave™ Siena graft to facilitate second stage repair either by conventional open vascular or endovascular techniques1.

GelweaveTM Gelatin Sealant Technology

Vascutek's trusted gelatin sealant technology delivers reduced thrombogenicity while maintaining excellent handling3,5.

Aortic arch and first stage "Elephant Trunk" procedures

A comprehensive range of product designs catering for a variety of both surgical techniques and patient needs when conducting the first stage surgical step of the "Elephant Trunk" technique. The product enables either a second stage surgical or endovascular procedure to be more easily performed.

Gelweave™ Siena Straight

Gelweave™ Siena

Gelweave™ Siena
4 Branch Plexus

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The Elephant Trunk technique has been shown to greatly facilitate and reduce the risk of multiple stage aortic replacement. [The Gelweave™ Siena graft] used in a modified Elephant Trunk technique was conceived to overcome the difficulties and the risks inherent in a large aneurysmal neck1.

Professor Eugenio Neri, Italy

Clinical Papers

Some of the clinical papers are listed below and are available on request

Total arch replacement with frozen elephant trunk technique

Ourania Preventza, Raed Al-Najjar, Scott A. LeMaire, Scott Weldon, Joseph S. Coselli 

Ann Cardiothorac Surg 2013;2(5):649-652

Aortic arch/elephant trunk procedure with SiennaTM graft and endovascular stenting of thoraco-abdominal aorta for treatment of complex chronic dissection

Randolph H.L. Wong, Max Baghai, Simon C.H. Yu, Malcolm J. Underwood 

Ann Cardiothorac Surg 2013;2(3):358-361

Staged total aortic hybrid repair for DeBakey type I dissection: Report of a case

Marco Di Eusanio, MD, PhD, Paolo Berretta, MD, Luigi Lovato, MD, and Roberto Di Bartolomeo, MD, Bologna, Italy 

The Journal of Thoracic and Cardiovascular Surgery c Volume 147, Number 4

Pan-aortic hybrid treatment of mega-aorta syndrome

Asad A. Shah, MD, Syamal D. Bhattacharya, MD, Richard L. McCann, MD, and G. Chad Hughes, MD, Durham, NC 


Instructions for Use

The standard Gelweave™ IFU is supplied with all Gelweave™ devices. Additional supplementary IFUs are provided based on the individual design of the Gelweave™ device.


  1. Neri et al., (2004) The “Elephant trunk” technique made easier. Annals Thoracic Surgery 78:17-18
  2. Adachi et al., (1997) Usefulness of a new branched sealed graft for the replacement of aortic arch. Jap J Art Organs 26:624-628
  3. Data on file at Vascutek Ltd
  4. Ehrlich et al., (1994) Operative management of aortic arch aneurysms using profound hypothermia and circulatory arrest. Int Congress Thoracic Thoracoabdominal Aortic Aneurysm 12-14 June: 23-26
  5. Gelseal Triaxial and Microvel Double Velour with Hemashield (Safepharm Report) (1989) by P C Jenkinson Bsc, Phd. Safepharm Laboratories Ltd, PO Box 45, Derby, DE1 2BT.


Gelweave™ Siena Collared Grafts with Tantalum Radiopaque Markers

Gelweave™ vascular prostheses with radiopaque markers were determined to be Magnetic Resonance (MR) conditional. Non-clinical testing determined that prostheses with radiopaque markers were MR conditional. A patient with this prosthesis can be scanned safely, immediately after placement of the prosthesis.

As for the standard branched grafts, the branches are used to accommodate reconstruction of the aortic branch vessels and intra-operative attachment to a perfusion cannula during cardiopulmonary bypass, especially where antegrade as opposed to retrograde perfusion techniques may be preferred.

Want to know more about GelweaveTM Siena?

Email us