Use of the Flixene vascular access graft as an early cannulation solution.
- Berard X Faculté de Médecine, Université Bordeaux, Bordeaux, France; Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France. Electronic address: xavier.berard@chu-bordeaux.fr.
- Ottaviani N Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
- Brizzi V Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
- Deglise S Vascular Surgery Department, CHUV de Lausanne, Lausanne, Switzerland.
- de Precigout V Nephrology Department, CHU de Bordeaux, Bordeaux, France.
- Ducasse E Faculté de Médecine, Université Bordeaux, Bordeaux, France; Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
- Combe C Faculté de Médecine, Université Bordeaux, Bordeaux, France; Nephrology Department, CHU de Bordeaux, Bordeaux, France.
- Midy D Faculté de Médecine, Université Bordeaux, Bordeaux, France; Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
- 2015-03-16
Published in:
- Journal of vascular surgery. - 2015
Aged
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Catheterization
Female
France
Graft Occlusion, Vascular
Humans
Kaplan-Meier Estimate
Kidney Failure, Chronic
Male
Middle Aged
Prospective Studies
Prosthesis Design
Renal Dialysis
Reoperation
Thigh
Time Factors
Treatment Outcome
Upper Extremity
Vascular Patency
English
OBJECTIVE
The primary end points of this study were safety and efficacy of early cannulation of the Flixene graft (Maquet-Atrium Medical, Hudson, NH). Secondary end points were complications and patency.
METHODS
This is a prospective single-center nonrandomized study. Study data included patient characteristics; history of vascular access; operative technique; interval between implantation and initial cannulation; complications; and patency at 1 month, 3 months, and every 6 months. Patency rates were estimated by the Kaplan-Meier method.
RESULTS
Between January 2011 and September 2013, a total of 46 Flixene grafts were implanted in 44 patients (27 men) with a mean age of 63 years. The implantation site was the upper arm in 67% of cases, the forearm in 11%, and the thigh in 22%. Seven grafts were never cannulated during the study period. Of the remaining 39 grafts, 32 (82%) were successfully cannulated within the first week after implantation, including 16 (41%) on the first day. The median interval from implantation to initial cannulation was 2 days (interquartile range, 1-3 days). The median follow-up was 223.5 days (interquartile range, 97-600 days). Five hematomas occurred, but only one required surgical revision. Primary assisted and secondary patency rates were 65% and 86%, respectively, at 6 months and 56% and 86%, respectively, at 1 year.
CONCLUSIONS
This study suggests that cannulation of the Flixene graft within 1 week after implantation is safe and effective. Early cannulation avoids or shortens the need for a temporary catheter. One-year patency rates appeared to be comparable to those achieved with conventional grafts, but long-term follow-up and randomized controlled studies will be needed to confirm this finding.
The primary end points of this study were safety and efficacy of early cannulation of the Flixene graft (Maquet-Atrium Medical, Hudson, NH). Secondary end points were complications and patency.
METHODS
This is a prospective single-center nonrandomized study. Study data included patient characteristics; history of vascular access; operative technique; interval between implantation and initial cannulation; complications; and patency at 1 month, 3 months, and every 6 months. Patency rates were estimated by the Kaplan-Meier method.
RESULTS
Between January 2011 and September 2013, a total of 46 Flixene grafts were implanted in 44 patients (27 men) with a mean age of 63 years. The implantation site was the upper arm in 67% of cases, the forearm in 11%, and the thigh in 22%. Seven grafts were never cannulated during the study period. Of the remaining 39 grafts, 32 (82%) were successfully cannulated within the first week after implantation, including 16 (41%) on the first day. The median interval from implantation to initial cannulation was 2 days (interquartile range, 1-3 days). The median follow-up was 223.5 days (interquartile range, 97-600 days). Five hematomas occurred, but only one required surgical revision. Primary assisted and secondary patency rates were 65% and 86%, respectively, at 6 months and 56% and 86%, respectively, at 1 year.
CONCLUSIONS
This study suggests that cannulation of the Flixene graft within 1 week after implantation is safe and effective. Early cannulation avoids or shortens the need for a temporary catheter. One-year patency rates appeared to be comparable to those achieved with conventional grafts, but long-term follow-up and randomized controlled studies will be needed to confirm this finding.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.jvs.2015.02.002
- PMID 25770983
- Persistent URL
- https://sonar.ch/global/documents/20353
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