MobiusHD<sup>®</sup> Device: Controlling Refractory Hypertension in ESRD
November 08, 2019 | 10:00 AM - 12:00 PM
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MobiusHD® Device: Controlling Refractory Hypertension in ESRD
Dialysis and Vascular Trainee Case Reports
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Trainee Case Report
- 1403 Hypertension and CVD: Mechanisms
- Hodgins, Spencer, UMMS Baystate Medical Center, Springfield, Massachusetts, United States
- Germain, Michael J., UMMS Baystate Medical Center, Springfield, Massachusetts, United States
Michael J. Germain,
We discuss an interesting case of a patient on dialysis with severe hypertension. As a life saving measure we were granted compassionate use of the MobiusHD device, a baroreflex modulator implanted in the carotid artery. We discuss the outcomes and potential benefits of this device seen in this case.
The patient is a 22-year old female with history of ESRD due to FSGS. She was diagnosed at a young age and underwent kidney transplantation at 11. She unfortunately went back on dialysis in 2016 at age 19 due to recurrent rejection and obstruction from a ureteric stricture. On dialysis she was noted to have extremely labile BP. In the 12 months prior to MobiusHD implantation, she had 22 admissions. Most were for hypertensive emergency requiring clevidipine. She also had an admission for PRES syndrome with seizures. Work up for secondary causes of hypertension was negative. Given the severity of her illness the MobiusHD device was implanted in Feb. 18 through Compassionate Use approval granted by the FDA. In the 12 months following MobiusHD implantation she had only 9 admissions (Fig. 1). We also evaluated her dialysis flowsheets and pre-dialysis systolic BP in her unit dropped from an average of 169.1 in the 6 months prior to the device to 152.5 in the 6 months following (Fig 2).
Our case highlights the potential benefits of the MobiusHD device in a patient with life-threatening complications due to hypertension. It is noted that up to 50% of dialysis patients have a blunted baroreflex response which suggests that this device may be helpful in this population.1,2 Since implantation of this device the patient has had a drastic improvement in quality of life and we are hoping to get her back on the transplant list with maintained stability.