Image: The ROX coupler joining iliac vessels (Photo courtesy of Rox Medical).
An innovative vascular coupling device tackles resistant high blood pressure (BP) by joining an artery and a vein together in the groin.
The Rox coupler is a small metal stent made of nitinol which when deployed, acts like a “paper-clip,” joining venous and arterial iliac vessels together in an anastomosis. This allows blood to flow between the high-pressure artery and the lower pressure vein. It is inserted and positioned via a laparoscopic procedure at the groin under local anesthesia in a cardiac or radiology catheterization lab. The procedure takes about one hour, does not require sedation, and is fully reversible by placing a covered stent over the arterial side of the anastomosis.
The Rox Coupler has also been studied in patients with severe chronic obstructive pulmonary disease (COPD). In these patients, its potential benefits may include improved breathing, reduced symptoms of chronic bronchitis, and improved exercise tolerance. It is possible that the procedure may increase the oxygen content (CaO2) in patients with hypoxemia and cardiac output, thereby increasing oxygen delivery to tissues (DO2). COPD patients may be able to walk farther, experience reduction in their severe COPD symptoms, and their quality of life may improve. The Rox coupler is a product of Rox Medical (San Clemente, CA, USA), and is currently undergoing a prospective randomized international study.
“Uncontrolled hypertension can lead to many other medical conditions with dire consequences. Patients with resistant hypertension have blood pressure way above normally accepted levels despite multiple medications in combination,” said professor of cardiac electrophysiology André Ng, MD, of Glenfield Hospital (Leicester, United Kingdom), who is participating in the study. “Uncontrolled hypertension can lead to many other medical conditions with dire consequences. Patients with resistant hypertension have blood pressure way above normally accepted levels despite multiple medications in combination.”