Aging, Arteriovenous Anastomosis, Blood Pressure, Humans, Hypertension, Risk Factors, Vascular Stiffness
ROX Medical, St Jude Medical, and Cardiosonic, and grants from Medtronic. ROX Medical funded the ROX CONTROL HTN study. ROX Medical; equity in Cibiem, Ablative Solutions, and Rainbow Medical; and personal fees from Abbott Ventures and Boston Scientific.
Raised blood pressure is the leading attributable risk factor for global morbidity and mortality. Real world data demonstrates that half of treated patients are at elevated cardiovascular risk because of inadequately controlled BP. In addition to pharmacotherapy, certain interventional strategies to reduce blood pressure and cardiovascular risk in hypertension can be considered according to international guidelines. One of the newer technologies entering this field is a proprietary arteriovenous coupler device that forms a fixed flow arteriovenous conduit in the central vasculature. In this review, we examine the development of and rationale for the creation of a central arteriovenous anastomosis in patients with hypertension and review the proposed mechanisms by which it may ameliorate hypertension. We critically review the clinical trial evidence base to date and postulate on future therapeutic directions.
Kapil V, Sobotka PA, Saxena M, Mathur A, Knight C, Dolan E, Stanton A, Lobo MD. Central iliac arteriovenous anastomosis for hypertension: targeting mechanical aspects of the circulation. Current Hypertension Reports. 2015;17(9):585.
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