Long-Term Outcomes of the Flixene Vascular Graft Used for Haemodialysis

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Abstract

The Flixene™ vascular graft (Maquet-Atrium Medical, Hudson, NH) has emerged as a new generation synthetic graft, which allows for early needling for hemodialysis. 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. From February 2011 to September 2019, 61 patients had 64 arteriovenous graft fistulas (AVGs) by using the Flixene grafts. An arteriovenous graft is created similarly to a fistula, connecting a vein to an artery, but it employs a plastic tube that is healed over by its surrounding tissue. Hemodialysis can be performed by inserting two needles on either side of the tube–arterial and venous. The average 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. The primary patency rate, secondary patency rate, and surgical complications were assessed. Results In a median follow-up of three years, 36 of the arteriovenous grafts required a fistulogram.  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.

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 arteriovenous grafts under an emergency setting to avoid the placement of a central venous catheter (CVC). This strategy should be advocated in future clinical practice.

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