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The Thrill of Success: Central Arterial-Venous Anastomosis for Hypertension


Excess blood pressure remains the most important risk factor for cardiovascular and renal disease. Poly pharmacy has been proved safe and effective under clinical trial circumstances; however, the majority of patients fail to sustain pharmaceutical persistence and adherence. The opportunity to offer patients a treatment or device in addition or perhaps instead of drug therapy alone may significantly broaden the options for patients and allow greater success in hypertensive therapy. In this review, we 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.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Conflict of Interest

Alice Stanton, Eamon Dolan, and Henry Krum declare no conflict of interest. Marat Fudim is a consultant for Cibiem, Inc. Paul A. Sobotka is a consultant for Abbott Ventures, Ardian, Boston Scientific, Medtronic, Nephera, and Ardelyx and is Chief Medical Officer for Cibiem and Rox Medical.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Henry Krum.

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This article is part of the Topical Collection on Device-Based Approaches for Hypertension

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Fudim, M., Stanton, A., Sobotka, P.A. et al. The Thrill of Success: Central Arterial-Venous Anastomosis for Hypertension. Curr Hypertens Rep 16, 497 (2014).

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  • Venous circulation
  • Blood volume
  • Shunt
  • Chemoreceptorsl
  • Cardio-pulmonary reflexes
  • Hypertension