Central Iliac Arteriovenous Anastomosis for Uncontrolled Hypertension: One-Year Results From the ROX CONTROL HTN Trial

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autorinnen und Autoren: Lobo MD, Ott C, Sobotka PA, Saxena M, Stanton A, Cockcroft JR, Sulke N, Dolan E, Van Der Giet M, Hoyer J, Furniss SS, Foran JP, Witkowski A, Januszewicz A, Schoors D, Tsioufis K, Rensing BJ, Scott B, Ng GA, Schmieder R
Zeitschrift: Hypertension
Jahr der Veröffentlichung: 2017
ISSN: 0194-911X
eISSN: 1524-4563


Abstract

Creation of a central iliac arteriovenous anastomosis using a novel nitinol coupler device results in an immediate, significant reduction of blood pressure (BP). We present efficacy and safety findings at 12 months post-coupler insertion. This open-label, multicenter, prospective, randomized trial enrolled patients with a baseline office systolic BP >=140 mm Hg and average daytime ambulatory BP >=135/85 mm Hg. Subjects were randomly allocated to coupler implantation and continuing previous pharmacotherapy or to maintain previous treatment alone. At 12 months, 39 patients who had coupler therapy were included in the intention-to-treat analysis. Office-based systolic BP reduced by 25.1±23.3 mm Hg (baseline, 174±18 mm Hg; P<0.0001) post-coupler placement, and office diastolic BP reduced by 20.8±13.3 mm Hg (baseline, 100±13 mm Hg; P<0.0001). Mean 24-hour ambulatory BP reduced by 12.6±17.4/15.3±9.7 mm Hg (P<0.0001 for both). In a prespecified subset of patients who failed to respond adequately to prior renal denervation, coupler therapy led to highly significant reduction in office systolic/diastolic BP (30.7/24.1 mm Hg) and significant reduction in 24-hour ambulatory systolic/diastolic BP (12.4/14.4 mm Hg) at 12 months (n=9). After coupler therapy, 14 patients (33%) developed ipsilateral venous stenosis; all were treated successfully with venous stenting. These findings confirm the importance of arterial mechanics in the pathophysiology of hypertension and support the clinical use of a central iliac arteriovenous anastomosis.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01642498.


FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Ott, Christian PD Dr.
Medizinische Fakultät
Schmieder, Roland Prof. Dr.
Professur für Innere Medizin (Nephrologie)


Einrichtungen weiterer Autorinnen und Autoren

Charité - Universitätsmedizin Berlin
Cliniques universitaires Saint-Luc (CHU St-Luc)
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Connolly Hospital Blanchardstown / Ospidéal Uí Chonghaile, Baile Bhlainséir
Eastbourne District General Hospital
East Sussex Healthcare NHS Trust
"Hippokration" General Hospital of Athens, Medical School
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Ohio State University
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ZNA Middelheim


Zitierweisen

APA:
Lobo, M.D., Ott, C., Sobotka, P.A., Saxena, M., Stanton, A., Cockcroft, J.R.,... Schmieder, R. (2017). Central Iliac Arteriovenous Anastomosis for Uncontrolled Hypertension: One-Year Results From the ROX CONTROL HTN Trial. Hypertension. https://dx.doi.org/10.1161/HYPERTENSIONAHA.117.10142

MLA:
Lobo, Melvin D., et al. "Central Iliac Arteriovenous Anastomosis for Uncontrolled Hypertension: One-Year Results From the ROX CONTROL HTN Trial." Hypertension (2017).

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Zuletzt aktualisiert 2018-07-10 um 03:08