“…The coupler device, which creates a central arteriovenous fi stula connecting the distal iliac vein and artery to reduce arterial resistance and pressure, is no longer in development. 14 In summary, device-based therapies for resistant hypertension hold promise, but more research is needed, particularly in patients with advanced CKD. These therapies remain investigational in the United States and are not currently approved by the US Food and Drug Administration for clinical use.…”