Safety of Venous Transvascular Autonomic Modulation
Authors: Arata M.
Venous Transvasular Autonomic Modulation (TVAM) has been recently described for patients with sympathetic autonomic nervous system (ANS) dysfunction. The hypothesized mechanism being balloon activation of the venous distention reflex. Herein we describe the feasibility and safety of this approach in the outpatient setting.
Material and Methods
Medical records for two hundred eighteen patients (139 Females, 79 Males), with a mean age 47.9 years (18-85), over a one year period were reviewed. Patients treated demonstrated symptoms of sympathetic ANS dysfunction. Autonomic dysfunction was confirmed by HRV and QSART testing. Treatment consisted of balloon dilation of both internal jugular, azygos and renal veins. Treatment goal of venous ballooning was activation of the venous distension reflex rather than correction of hemodynamic abnormalities. All procedures were performed in an office based endovascular treatment center. Clinical assessment was made in the immediate and twenty four hour post-procedure periods. Post-procedure imaging was by Doppler or magnetic resonance venogram (MRV) (114 Ultrasound, 104 MRV).
The TVAM procedure was successfully completed in all cases (technical success of 100%). Acute adverse events did not occur during any of the procedures within 24 hour follow-up period. Post-procedure imaging demonstrated no vascular adverse events.
Conclusion: Outpatient performance of venous autonomic modulation appears safe. Replication and validation of these results are encouraged.