Compliance - The Next Frontier in Aortic Repair

The Problem

The aorta is the largest artery connected to the heart and acts both as a conduit and an elastic chamber. The aorta's elasticity (Windkessel function) serves to convert the heart's pulsatile flow to a nearly steady flow in peripheral vessels. Current treatment for aortic disease ranges from open surgical replacement to endovascular placement of stent-grafts excluding the diseased part of the aorta.  Two materials are mainly used for vascular and endovascular prostheses: Dacron, a knitted or woven PET fabric or ePTFE (Gore-Tex). These materials are cheap, durable and with adequate pretreatment also blood-tight but are basically non-compliant

This lack of compliance is a problem in the treatment of all aortic pathologies as this leads to an increase of the pulse wave velocity, an increase in the afterload for the heart, can lead to arterial hypertension, requiring additional antihypertensive medication and in some patients ultimately to the deterioration of the left ventricular function. With an aging society the incidence of aortic disease is rising, reflected by a growing number of vascular and endovascular procedures to treat aortic pathologies.

The Solution

Ascense Medical, a start-up based in Vienna, Austria, is developing a compliant material for vascular and endovascular grafts, that mimicks the native elasticity and compliance of the human aorta to maintain the aorta's Windkessel function. 

The Windkessel function of the aorta is important to maintain physiologic blood pressure and physiologic aortic flow pattern. The compliant vascular and endovascular prostheses that Ascense Medical is currently developing will reduce the long-term sequelae of current vascular grafts and stent-grafts and should reduce overall healthcare costs via a reduction of short-term and long-term sequelae seen with conventional non-compliant prostheses.