Defeating the Silent Killer

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Endologix is bringing league-leading innovations to the treatment of patients with aortic disease

It’s the 10th leading cause of death in men over 55, and the 15th leading cause of death overall in America. It’s brewing right beneath your radar, because that’s what abdominal aortic aneurysms do: grow in lethal silence until they rupture and rob you of your existence.

The human body’s largest blood vessel, the aorta, delivers oxygenated blood from the heart to the circulatory system. It extends from the left ventricle of the heart, in front of the backbone, and down the trunk. When the aortic wall weakens it eventually bulges, creating an aneurysm. As the aneurysm continues to grow and further weaken the aorta, the risk of bursting increases; a rupture will cause sudden, life-threatening bleeding and a high chance of death.

Aneurysms occurring in the chest are called thoracic aneurysms, and those that develop in the midsection are known as abdominal aortic aneurysms, or AAA.

Most people have no symptoms, and while certain hereditary and behavioral factors help clinicians define the most at-risk populations, there’s not a single definitive root cause of AAA. That said, atherosclerosis, a buildup of plaque in the inner lining of artery walls, is considered one risk factor, as is age and a history of smoking.

Established in 1992, Endologix is singularly focused on the treatment of abdominal aortic aneurysms, pioneering minimally invasive medical devices to treat diseases of the abdominal aorta, including AAA.

“Endologix has a very disruptive portfolio that’s differentiated from everything else. Its new innovation is in a relatively early stage, and it is the chance to put that innovation into surgical practice that was so attractive for me to join the company,” reported company Chief Medical Officer, Matt Thompson, MD.

Just over two years ago, Thompson left London’s illustrious St. George Vascular Institute after 14 years to contribute his expertise to the Irvine, CA-based medical device developer. “I’d focused my clinical practice entirely in the last few years on patients with aortic aneurysm,” he explained.

“Technological disruption in medical devices can translate into improved outcomes for patients both in terms of the patients who are treated and also the proportion of patients who are suitable for different treatments.”

Prior to the development of minimally invasive, endovascular “keyhole” surgery to repair the aorta, patients would need to endure open abdominal surgery to repair the damaged section of blood vessel and replace it with a surgical graft.

Lengthy recoveries and the increased risk of complications make open surgery a much riskier proposition than the revolutionary endovascular approaches such as those developed by Endologix. “It takes anywhere from three to six months to get over an open surgical procedure,” Thompson noted. “It’s about three to six weeks to recover fully from an endovascular repair, so that tells you the order of magnitude difference we see with keyhole surgery.”

Endovascular aneurysm repair (EVAR) employs small delivery devices (inserted in the aorta through the groin) to place a stent in the aorta. When the delivery devices come out, the stent stays in place to exclude the damaged aortic wall.

“The two primary unmet needs that we’re trying to solve at Endologix are increasing patients’ access to endovascular procedures, and the long-term durability of the endovascular procedure,” Thompson stressed. “We want to increase the proportion of patients who can have endovascular repair by using polymer-based technologies that minimize the graft delivery systems and give a custom-made seal inside the aneurysm. We’re also focused on solutions to optimize the adaptive nature of the grafts to give a very clear seal within the aneurysm and increase the durability of the graft.”

The company’s groundbreaking, FDA-approved Ovation® abdominal stent graft platform treats the widest range of AAA anatomies and is a clinically proven, minimally invasive solution for patients with abdominal aortic disease.

Endologix has anatomically adaptive endovascular graft systems with its approved AFX® and Ovation® products. Additionally, they have an investigative device, used in clinical trials, that is the only solution that completely seals the aneurysm. Ovation and this investigative device are based on polymer technology used to enhance a fabric covered stent. The amazing part? The polymer is injected into the aorta as a liquid during the actual procedure. The liquid sets into a hydrogel inside the body and customizes to the exact shape and size of the aorta.

“That allows us to essentially injection mold the graft within the aneurysm so that it adapts perfectly to the aorta and creates a very durable, long lasting seal. The other advantage of using polymer technology to actually construct the endograft inside the patient is that we can minimize the graft because you don’t actually have the structure packed inside your delivery catheter.”

The AFX® Endovascular AAA System is seated to the aorta at its natural division, making the area more accessible if surgical intervention is needed down the line. Currently an investigative device used in clinical trials, the Nellix® technology is the only solution created to seal the entire aneurysmal sac, representing a potential advancement in AAA therapy.

“We think we are the company that can make the biggest difference in the lives of patients with AAA. That’s what we’re driving towards,” Thompson concluded.