Minimally Invasive System Helps Modulate Blood Pressure

A novel implant mechanically amplifies signals received by arterial baroreceptors, leveraging the body’s natural tendency to lower resistant hypertension by vasodilation.

The MobiusHD is a passive implant designed to reshape the carotid sinus in the diastolic phase and prevent vessel migration in the systolic phase; the reshaping of the vessel results in an increased radius with every pulsatile wave, which is concentrated within the windows of the implant. As the radius of the vessel is directly proportional to strain in the sinus wall, the baroreceptors perceive it as an increase in pulsatile blood pressure and increase afferent signaling to the medulla, resulting in a commensurate reduction in blood pressure.

The nitinol implant is available in three different sizes for vessels with diameters ranging from 5.0 to 11.75 mm. Delivery is via percutaneous coronary intervention (PCI) to the carotid bulb, where the carotid arterial baroreceptors are concentrated. The MobiusHD is a product of Vascular Dynamics (Mountain View, CA, USA) and has received the European Community (CE) marking of approval. The company is conducting a prospective multicenter study in the US and Europe with the primary endpoint being safety at six months post-procedure.

“Receiving CE Mark approval for the treatment of resistant hypertension is a major milestone for our company as we validate our novel solution for the millions of people whose hypertension is not adequately controlled by drugs,” said Robert Stern, President and CEO of Vascular Dynamics. “Initial results suggest significant improvement in the average blood pressure readings post barostenting procedure.”

“I’ve seen numerous approaches to controlling resistant hypertension over the years. Most drugs have side effects leading to poor compliance, and more invasive approaches have other drawbacks,” said Gregg Stone, MD, director of cardiovascular research and education at Columbia University Medical Center (CUMC; New York, NY, USA). “The minimally invasive MobiusHD barostenting procedure could be life changing for this patient population, while also reducing the cost of healthcare.”

Baroreceptors are stretch-sensitive fibers located in the aortic arch and the carotid artery sinus. Their activation triggers an afferent nerve negative-feedback signal to the medulla that helps maintain normal arterial pressure. When working normally, baroreceptors buffer blood pressure fluctuations by causing reflex-mediated reciprocal changes in heart rate and sympathetic nerve activity, thus keeping arterial pressure at a predetermined operating level. However, in patients with chronic hypertension, the elevations in pressure threshold can result in decreased baroreceptor activity.

Related Links:
Vascular Dynamics
Columbia University Medical Center