The Elephant Trunk Technique made easier - Gelweave™ Siena

Elephant Trunk procedure made easier

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 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.

Aortic arch Plexus

Aortic Arch Plexus
facilitates individual arch vessel reconstruction2

Excellent handling

technology with excellent handling3

Radiopaque markers

Radiopaque markers
facilitate 2nd stage repair1


Aortic arch and first stage "Elephant Trunk" procedures


Gelweave Siena Straight

Gelweave™ Siena


Gelweave Siena ante-Flo

Gelweave™ Siena


Gelweave Siena Plexus

Gelweave™ Siena

4 Branch Plexus


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 features

Aortic Arch Plexus

Facilitates individual arch vessel reconstruction2

Gelweave plexus close up
Gelweave ante-flo side branch

Ante-Flo side branch

Enables lower body reperfusion and earlier patient re-warming4.


GelweaveTM Siena Collar

Compensates for diameter mismatch between distal aorta and graft, reducing tension on the distal anastomosis, potentially reducing the risk of aneurysm rupture before the second stage repair1.

Gelweave Siena collar
Gelweave Siena collar

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.

Gelweave gelatin sealant technology


Product availability and use of product for debranching and associated hybrid procedures are subject to local regulatory approval.

Gelweave™ Siena - implantation

The "Elephant Trunk" Procedure


This film demonstrates the product being used for a first stage surgical procedure and second stage endovascular completion.


Aortic Surgery / Aortic Dissection Unit - Siena University Hospital - Italy
Dr Eugenio Neri, Dr Enrico Tucci, Dr Muzzi Luigi, Dr Antonio Benvenuti, Dr Giulio Tommasimo

Interventional Radiology Unit Siena University Hospital
Dr Cameron Ricci, Dr Marco Cini, Dr Francesco Vigini

The "Elephant Trunk" Technique made easier


Surgical procedures for the treatment of complex aortic arch pathology remain among the most challenging cardiovascular operations, incurring considerable risk for death and stroke. Specifically, advancements in techniques, cerebral protection, arch reconstruction with [branched grafts] and the classical and Frozen Elephant Trunk techniques have revolutionized the field and simplified the conduct of the operation6.


The Gelweave™ Siena implantation guide offers insight into the stages of procedure.

Flexibility and precision


Click and drag on the image to see a 360° view of the Gelweave™ Siena graft.