Central iliac arteriovenous anastomosis for hypertension: targeting mechanical aspects of the circulation.
Vikas Kapil
Paul A. Sobotka
Manish Saxena
Anthony Mathur
Charles Knight
Eamon Dolan
Alice V. Stanton
Melvin D. Lobo
10779/rcsi.10782260.v1
https://repository.rcsi.com/articles/journal_contribution/Central_iliac_arteriovenous_anastomosis_for_hypertension_targeting_mechanical_aspects_of_the_circulation_/10782260
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.
2019-11-22 16:18:52
Aging
Arteriovenous Anastomosis
Blood Pressure
Humans
Hypertension
Risk Factors
Vascular Stiffness
Clinical Pharmacology and Therapeutics