Arteriovenous Anastomosis — Another Device to Control Hypertension?

In patients with uncontrolled hypertension, interventional antihypertensive approaches have targeted baroreflex activation and renal sympathetic denervation. Now, researchers have tested an investigational, minimally invasive device to create a central iliac arteriovenous fistula, thereby lowering blood pressure through mitigation of arterial stiffness, a mechanism unaffected by sympathomodulation.

In this industry-sponsored, open-label, multicenter, randomized trial, 83 hypertensive patients (baseline office systolic blood pressure, ≥140 mm Hg; average daytime ambulatory blood pressure, ≥135 mm Hg systolic and ≥85 mm Hg diastolic) were randomly assigned to undergo percutaneous implantation of the device plus current treatment or to continue…