Procedure Illustrations

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Melvin D. Lobo, Paul A. Sobotka, Alice Stanton, John R. Cockcroft, Neil Sulke, Eamon Dolan, Markus van der Giet, Joachim Hoyer, Stephen S. Furniss, John P. Foran,  Adam Witkowski, Andrzej Januszewicz, Danny Schoors, Konstantinos Tsioufis, Benno J. Rensing, Benjamin Scott, G André Ng, Christian Ott, Roland E. Schmieder, for the ROX CONTROL HTN investigators.

Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomised controlled trial.

The authors discuss the results of the RH-02 clinical trial. They assessed the safety and efficacy of a central iliac arteriovenous anastomosis to alter the mechanical arterial properties and reduce blood pressure in patients with uncontrolled hypertension.

John P. Foran, Ajay K. Jain, Ivan P. Casserly, David E. Kandzari, Krishna J. Rocha-Singh, Adam Witkowski, Barry T. Katzen, David Deaton, Peter Balmforth, Paul A. Sobotka.

The ROX coupler: Creation of a fixed iliac arteriovenous anastomosis for the treatment of uncontrolled systemic arterial hypertension, exploiting the physical properties of the arterial vasculature

The authors describe the technical aspects of the ROX coupler device and implantation procedure, results from a preclinical study, patient selection criteria, and potential complications of this therapy for uncontrolled hypertension.

John L. Faul, Sophie Brouwers, Benjamin Scott, Andreas Jerrentrup, Joseph Galvin, Sandra Luitjens, Eamon Dolan.

Creation of an iliac arteriovenous shunt lowers blood pressure in chronic obstructive pulmonary disease patients with hypertension, Journal of Vascular Surgery, 2014 Apr; 59(4): 1078-83

The authors discuss the findings of a twenty-four patient open label study of arteriovenous shunt creation in patients with COPD and hypertension.  The authors conclude that a percutaneous iliac arteriovenous fistula creation for COPD causes a significant and persistent lowering of blood pressure for those with co-existing hypertension.

Marat Fudim, Alice Stanton, Paul Sobotka, Eamon Dolan, Henry Krum.

The Thrill of success: central arterial-venous anastomosis for hypertension, Current Hypertension Reports, 2014 December; 16(12):1522-6417 (Print) 1534-3111 (Online)

The authors examine the potential of a fixed-volume central arterial-venous anastomosis to reduce blood pressure in hypertensive patients, review possible mechanisms by which the anastomosis may reduce blood pressure, and consider the unique clinical trial opportunities posed by this therapy.

Christopher B. Cooper, Bartolome Celli.

Venous Admixture in COPD: Pathophysiology and Therapeutic Approaches, COPD, 2008 December; 5(6): 376–381.

The authors discuss in this perspective article the mechanism whereby venous admixture contributes to hypoxemia and reduced oxygen delivery to tissues. They explore methods which could potentially increase mixed venous oxygen content thus ameliorating the deleterious effects of venous admixture. The authors believe this approach to treatment could have significant impact for patients with COPD but should also benefit any patient with chronic hypoxemia that impairs exercise performance.

John L. Faul, Horst Sievert.

Percutaneous Creation of Arteriovenous Shunts, Vascular Disease Management, 2008 September/October; 5(5): 128-133.

Discusses the rationale for creating arteriovenous (AV) shunts in humans and describes novel techniques for percutaneous creation of AV shunts in patients. In this study, the acute effects of an AVF on mixed venous oxygen content and arterial oxygenation during hypoxia in pigs were examined. The authors conclude that the creation of an AVF improves oxygen delivery during hypoxia and might benefit patients with respiratory disease.

John L. Faul, Christopher B. Cooper, Juan Galindo, Rodolfo Posada-Valay, Guillermo Elizondo-Riojas, Angel Martinez.

An Arteriovenous Fistula Increases Exercise Capacity in Patients with COPD, Chest, 2010 July, 138: 52-57.

The article discusses how an ileofemoral arteriovenous fistula increased 6-minute walking distance in patients with severe COPD, matching the improvement seen with supplemental oxygen. An initial response to supplemental oxygen predicted a therapeutic response to the AVF.