It's not so much a .net question as it is an IIS question.
Basically, IIS looks at what extension is being requested and responds accordingly.
There is a list of all file extensions and what actions should be taken when these are requested. In terms of .net, these are .aspx, .ascx, asmx, etc. These are basically ISAPI filters.
Depending on your version of IIS. If you open IIS Manager, choose the website in question, go to Properties, then Home Directory, then Configuration, under Mappings you will see all file extensions and the application that will be called to action this request.
Therefore, if you add an entry for .vato, and point it to your version of .net, such as C:\WINDOWS\Microsoft.NET\Framework\v2.0.50727\aspnet_isapi.dll then the .vato file will then be treated the same as a .aspx files.