Chiang Nathaniel, Hulme Katherine Ria, Haggart Paul Charles, Vasudevan Thodur
Waikato Hospital, Hamilton - New Zealand.
J Vasc Access. 2014 Mar-Apr;15(2):116-22. doi: 10.5301/jva.5000213. Epub 2014 Feb 10.
The purpose is to compare the outcomes of FLIXENE™ arteriovenous graft (AVG) to standard polytetrafluoroethylene (PTFE) AVG for early haemodialysis.
This is a prospective observational study of all AVGs placed over a 40-month period between 2008 and 2011 at our vascular unit. Primary outcome was to examine early cannulation rates for FLIXENE™. Secondary outcomes included patency rates, usability of grafts, complications in particular infections, interventions and death in comparison to standard PTFE grafts.
Forty-five FLIXENE™ and 19 standard PTFE AVGs were placed in the study period; 89% of FLIXENE™ grafts were used for dialysis, with 78% cannulated within 3 days. At 18 months, primary patency (FLIXENE™ 34% vs standard PTFE 24%), primary assisted patency (35% vs 36%) and secondary patency rate (51% vs 48%) were not statistically different; 20.2% of FLIXENE™ grafts were infected at 18 months requiring explantation compared with 40.3% of standard PTFE grafts (p=0.14).
FLIXENE™ can be cannulated for dialysis within 3 days. It has similar patency and complication rates as other prosthetic grafts in the market. In patients who have no access and require urgent dialysis, FLIXENE™ is a viable option.
比较FLIXENE™动静脉移植物(AVG)与标准聚四氟乙烯(PTFE)AVG用于早期血液透析的效果。
这是一项对2008年至2011年期间在我们血管科40个月内植入的所有AVG进行的前瞻性观察研究。主要结局是检查FLIXENE™的早期插管率。次要结局包括通畅率、移植物的可用性、与标准PTFE移植物相比的并发症,尤其是感染、干预措施和死亡情况。
在研究期间植入了45个FLIXENE™和19个标准PTFE AVG;89%的FLIXENE™移植物用于透析,其中78%在3天内进行了插管。在18个月时,原发性通畅率(FLIXENE™为34%,标准PTFE为24%)、原发性辅助通畅率(35%对36%)和继发性通畅率(51%对48%)无统计学差异;18个月时,20.2%的FLIXENE™移植物发生感染需要取出,而标准PTFE移植物为40.3%(p = 0.14)。
FLIXENE™可在3天内用于透析插管。其通畅率和并发症发生率与市场上其他人工移植物相似。对于没有血管通路且需要紧急透析的患者,FLIXENE™是一个可行的选择。