Department of Vascular Surgery, Singapore General Hospital, Singapore.
Health Services Research Center, SingHealth, Singapore.
Ann Vasc Surg. 2021 May;73:171-177. doi: 10.1016/j.avsg.2020.11.029. Epub 2020 Dec 26.
The aim of this study was to review the efficacy of the Flixene™ (Atrium™, Hudson, NH, USA) hemodialysis arterio-venous graft (AVG) in a multiethnic Asian cohort of patients with end-stage renal failure (ESRF). Primary outcome was graft primary patency rate and secondary end points included graft usability, time to cannulation, reinterventions required for access salvage, complications, and patient mortality.
Single-center, single-arm, multi-investigator nonrandomized retrospective study. Patients with ESRF who underwent Flixene™ graft implantation over a two-year period (January 2017 - December 2018) were included to allow at least one-year follow-up. Demographics, procedural and follow-up data were collected from the hospital electronic medical records.
About 48 patients (49 AVG) were included. There were 24 (50%) men; mean age 63.7 (IQR 58.2-71.3) years. Technical success rate was 45/49 (91.8%); 4/49 (8.2%) AVG created did not reach cannulation. 11/49 (22.4%) and 28/49 (57.1%) achieved cannulation within 1 and 2 weeks, respectively. 6- and 12- month primary patencies were 33.5% and 19.6%, respectively. Primary-assisted patency rates were 46.6% and 29.6% at the same time intervals. Secondary patency rate was 77.6% and 63.9% at 6 and 12 months, respectively. There were 6 (12.2%) graft infections requiring explant and one-year mortality was 14%.
Our experience with the Flixene™ early cannulation graft is comparable with other AVGs in terms of patency and infection rates. However, early cannulation rates are lower than in other case series.
本研究旨在回顾 Flixene™（Atrium™，哈德逊，新罕布什尔州，美国）血液透析动静脉移植物（AVG）在终末期肾衰竭（ESRF）的多民族亚洲患者队列中的疗效。主要结果是移植物原发性通畅率，次要终点包括移植物可用性、置管时间、挽救通路所需的再介入、并发症和患者死亡率。
单中心、单臂、多研究者非随机回顾性研究。纳入 2017 年 1 月至 2018 年 12 月期间接受 Flixene™ 移植物植入术的 ESRF 患者，以确保至少有一年的随访。从医院电子病历中收集人口统计学、程序和随访数据。
共纳入 48 例患者（49 个 AVG）。24 例（50%）为男性；平均年龄 63.7（IQR 58.2-71.3）岁。技术成功率为 45/49（91.8%）；4/49（8.2%）个 AVG 未达到置管。11/49（22.4%）和 28/49（57.1%）分别在 1 周和 2 周内达到置管。6 个月和 12 个月的原发性通畅率分别为 33.5%和 19.6%。同期主要辅助通畅率分别为 46.6%和 29.6%。二级通畅率分别为 6 个月和 12 个月的 77.6%和 63.9%。有 6 例（12.2%）移植物感染需要取出，1 年死亡率为 14%。
我们使用 Flixene™早期可置管移植物的经验在通畅率和感染率方面与其他 AVG 相当。然而，早期置管率低于其他病例系列。
