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Gloved hand holding a hydrated envelope that conforms around the hand.

CanGaroo™ Envelope

The CanGaroo Envelope is designed to conform to cardiac implantable electronic devices (CIEDs). It is an acellular biomatrix comprised of extracellular matrix from porcine small intestine submucosa (SIS ECM).
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How it works

A hydrated envelope wrapped around the battery of a dual chamber pacemaker on a surgical table.

CanGaroo leverages extracellular matrix (ECM) technology to support the biologic healing response, helping decrease inflammation and support the formation of healthy tissue.1,2 As a biomatrix, CanGaroo creates a hospitable environment for the patient’s own cells to migrate into the material and initiate tissue remodeling.3,4

This biomatrix supports key processes involved in tissue repair, including cell adhesion, differentiation, division, and migration.4 By promoting natural wound healing mechanisms, CanGaroo helps develop structural tissue that matures over time into a strong, permanent repair.4

Why choose the CanGaroo Envelope?

CanGaroo remodels into a healthy, vascularized pocket.3

Outlined heart silhouette with a steady heartbeat, illustrating support for conforming and integration.

Conform and integrate

CanGaroo easily conforms to the shape of the CIED. Once implanted, the CanGaroo Envelope creates a hospitable environment for the surrounding cells to migrate into the bioscaffold and start matrix turnover.3,4

Outlined band aid, illustrating that CanGaroo supports healing

Support healing

The extracellular matrix helps guide the body's healing response after implantation, reducing inflammation and supporting constructive tissue healing.1,2

Stethoscope with a checkmark, symbolizing a stable, secure environment for a cardiac implant.

Stabilize and support

As remodeling concludes, the CIED is secured naturally with the new tissue.1 The result is systemically connected vascularized tissue that surrounds the device.1

Clinical challenges and patient types

Explore clinical scenarios and patients who might benefit from the biologic features of the CanGaroo™ Envelope.

Clinical challenge

First-time implant patients may benefit from added tissue support and long-term pocket management, especially if future change-outs are anticipated.​

How the CanGaroo Envelope may help

CanGaroo remodels into healthy, vascularized tissue, which may support long-term pocket health and may be beneficial for younger patients who may require multiple change-outs over their lifetimes.1

Key features & biologic mechanism​

  • SIS ECM remodels into healthy vascularized tissue.1
  • Promotes a natural biologic healing response.1

Clinical challenge

Patients with thin skin may be at risk for erosion and may benefit from an added layer that supports the securing of the device.​

How the CanGaroo Envelope may help

CanGaroo may provide an added soft layer around the device to help reinforce the pocket and support secure placement..1

Key features & biologic mechanism​

  • Provides a soft layer around the device.1
  • Promotes remodeling of tissue; soft, suturable edges help support placement.1

Clinical challenge

Patients who need added device stabilization may be at risk for migration.​

How the CanGaroo Envelope may help

CanGaroo provides a soft layer around the device which helps anchor the CIED, naturally mitigating risk of migration. CanGaroo may also facilitate device implant by providing additional anchoring points. 1,5-6

Key features & biologic mechanism​

  • Soft layer around the device.1,5-6
  • Additional anchoring points.1,5-6
  • Suturable soft edges.1,5-6
  • Biologic remodeling supports long-term stabilization.1,5-6

Clinical challenge

Patients may benefit from healthy tissue support, and protection of the therapy delivery.​

How the CanGaroo Envelope may help

CanGaroo helps facilitate the growth of healthy remodeled tissue surrounding the S-ICD. The healthy tissue may protect both the sensing and shocking vector. 1,5-6

Key features & biologic mechanism​

  • Protection of therapy.1,5-6
  • Revascularized tissue around the device.1,5-6

Clinical challenge

Calcification may be a concern in long-term tissue response around implanted devices.​

How the CanGaroo Envelope may help

SIS ECM has been shown to naturally resist calcification.4

Key features & biologic mechanism​

  • A preclinical study demonstrated that SIS ECM material is naturally resistant to calcification.4

Clinical challenge

Implant procedures with a bioenvelope may benefit from easier handling, placement, and pocket management.​

How the CanGaroo Envelope may help

CanGaroo is designed to create a healthy pocket environment while easily conforming to the shape of the CIED and to stabilize the device in the pocket.4

Key features & biologic mechanism​

  • The envelope's opening allows for CIED insertion and lead exit.4
  • Natural lubricity when hydrated allows for easy handling and placement.4
  • Perforations are designed to prevent fluid collection.4
  • Suturable soft edges allow the envelope to easily slide into place without the need to upsize the device pocket.4

Clinical challenge

Device rotation within the pocket can place stress on the leads and compromise device function, creating a need for secure device positioning and long-term pocket stabilization.​

How the CanGaroo Envelope may help

CanGaroo may support secure device placement by providing a soft layer around the CIED, additional anchoring points, and biologic remodeling that supports long-term stabilization within the pocket.1,5

Key features & biologic mechanism​

  • Soft layer around the device.1,5
  • Suturable soft edges.1,5
  • Additional anchoring points.1,5
  • SIS ECM remodels into healthy, vascularized tissue to support long-term pocket stability.1,5

Implant technique

Prior to use, review the IFU for full operating instructions.

CanGaroo offers a quick, easy implant technique that fits your workflow. 

Two BioEnvelope pouches shown side by side in different sizes.

Step 1:

To use, select the appropriate size CanGaroo for the CIED. Handle the sterile envelope using aseptic technique. 

A BioEnvelope being dipped into sterile solution for hydration.

Step 2:

Hydrate CanGaroo by completely immersing it in sterile solution (water, saline or lactated Ringers) for 1-2 minutes.

A CIED being inserted into a BioEnvelope with lead wires extending from the opening.

Step 3:

Slide the CIED into CanGaroo, with lead wires emerging out of the opening. Secure the bioenvelope with one stitch.

A BioEnvelope containing a CIED being positioned into the surgical chest pocket.

Step 4:

Implant the CIED with the bioenvelope into the pocket and secure it to the fascia per standard practice.

Ordering information

Product DescriptionModel Number 
CanGaroo Envelope
Size 1 		BC01
CanGaroo Envelope
Size 2		BC02
CanGaroo Envelope
Size 3		BC03
CanGaroo Envelope
Size 4		BC04
CanGaroo Envelope
Size 5		BC05
CanGaroo Envelope
5PK Size 1  		BC11
CanGaroo Envelope
5PK Size 2		BC12
CanGaroo Envelope
5PK Size 3 		BC13
CanGaroo Envelope
5PK Size 4 		BC14
CanGaroo Envelope
5PK Size 5 		BC15

Technical specifications

Size Model numberDimensions Recommended device size 
Size 1
BC01 5.0 cm x 5.4cmSingle Chamber Pacemaker 
Size 2
BC026.5cm x 6.9cm Pacemaker 
Size 3
BC03 8.0cm x 6.9cmICD 
Size 4
BC04 9.5cm x 6.9cmCRT-D and ICD 
Size 5
BC05 8.9cm x 10.8cmS-ICD 
CanGaroo BioEnvelope sizes 1-5

CanGaroo Envelope

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References:​

  1. *Deegan D, et al. J Regen Med.2022;11:5. doi:10.4172/2325-9620.1000226
  2. *Dziki JL, et al. J Biomed Mater Res A. 2017;105(1):138–147. doi:10.1002/jbm.a.35894
  3. Catanzaro JN, et al. Front Cardiovasc Med. 2025;12:1638929. doi:10.3389/fcvm.2025.1638929
  4. **.Sündermann SH, et al. Thorac Cardiovasc Surg. 2014 Feb;62(1):76-79. doi:10.1055/s-0032-1328920
  5. **.Xiang K, et al. HeartRhythm Case Rep. 2019;5(8):430-432. doi:10.1016/j.hrcr.2019.05.003.CanGaroo IFU
  6. Piterina AV et al. Int J Mol Sci. 2009;10(10):4375-4417. doi:10.3390/ijms10104375

*Bench Test or pre-clinical study results may not necessarily be indicative of clinical performance. **Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.