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With projected power densities above 100 W/cm2 for devices, new methods for thermal management from the heat generation at the die to heat removal to the ambient must be addressed. By integrating micro heat pipes directly within the ceramic substrate, effective thermal conductivity for spreading heat in both radial and axial directions was achieved. New materials and processes were developed to fabricate the unique components required to handle high thermal loads. Enhanced thermal vias to minimize the thermal impedance through the ceramic in the evaporator and condenser sections were developed, increasing the effective thermal conductivity from 2.63 to near 250 W/m-°C. The use of an organic insert fabricated into the desired complex shape using rapid prototyping methods, coupled with the viscoelastic flow of the low temperature cofire ceramic (LTCC) during lamination, allowed complex shapes to be developed while ensuring uniform green tape density during lamination prior to tape firing. Large cavities, three-dimensional fine structures and porous wicks for capillary 3-D flow have been utilized to fabricate the heat pipes. Heat pipes and spreaders, utilizing water as the working fluid, have been demonstrated operating with power densities in excess of 300 W/cm2.