He Bulang, Tailor Duxxa, Ng Zi Qin, Samuelson Shaun, Nadkarni Sanjay, Van Myk Matt, Ferguson John, Tibballs Jonathan, Chan Doris
Western Australia (WA) Liver and Kidney Transplant Service, Sir Charles Gairdner Hospital, University of Western Australia, Perth, AUS.
Department Renal Surgery and Transplant, Austin Hospital, Victoria, AUS.
Cureus. 2021 Feb 20;13(2):e13459. doi: 10.7759/cureus.13459.
Introduction The Flixene™ vascular graft (Maquet-Atrium Medical, Hudson, NH) has emerged as a new generation synthetic graft, which allows for early needling for haemodialysis. Most studies have shown satisfactory early results. The aim of this study is to report on long-term outcomes of the Flixene graft over eight years in a cohort of patients. Methods From February 2011 to September 2019, 61 patients had 64 arteriovenous graft fistulas (AVGs) by using the Flixene grafts. The median patient age was 67 years; the male to female ratio was 30:31. Diabetes was the reason for the majority of kidney failures (57%). The configuration of the grafts used was mostly upper arm straight AVG. The primary patency rate, secondary patency rate, and surgical complications were assessed. Results In a median follow-up of three years (interquartile range (IQR): 2 - 6), 36 of the AVGs required a fistulogram. Venous side stenosis was the most common cause of high venous pressure or AVG occlusion in 97%. The one-year primary patency rate was 30%. The secondary patency rate was 94.8%, 83.7%, and 77.7% at one, three, and five years, respectively. The longest functional AVG was observed for up to seven years. Conclusions This study has shown satisfactory long-term results of the Flixene graft used for hemodialysis. The Flixene graft could be needled within 72 hours without increased complications, which allows the creation of an AVG under an emergency setting to avoid the placement of a central venous catheter (CVC). This strategy should be advocated in future clinical practice.
Flixene™血管移植物（马奎特-中庭医疗公司，新罕布什尔州哈德逊）已成为新一代合成移植物，可用于早期进行血液透析穿刺。大多数研究显示早期结果令人满意。本研究旨在报告一组患者使用Flixene移植物超过八年的长期结果。方法：从2011年2月至2019年9月，61例患者使用Flixene移植物建立了64个动静脉移植物内瘘（AVG）。患者年龄中位数为67岁；男女比例为30:31。糖尿病是大多数肾衰竭的原因（57%）。所使用移植物的构型大多为上臂直型AVG。评估了主要通畅率、次要通畅率和手术并发症。结果：在中位随访三年（四分位间距（IQR）：2 - 6）期间，36个AVG需要进行瘘管造影。静脉侧狭窄是97%的高静脉压或AVG闭塞的最常见原因。一年主要通畅率为30%。一年、三年和五年的次要通畅率分别为94.8%、83.7%和77.7%。观察到最长的功能性AVG长达七年。结论：本研究显示使用Flixene移植物进行血液透析的长期结果令人满意。Flixene移植物可在72小时内进行穿刺且不增加并发症，这使得在紧急情况下能够建立AVG以避免放置中心静脉导管（CVC）。该策略应在未来临床实践中得到提倡。
