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

Bulang He; Duxxa Tailor; Zi Qin Ng; Shaun Samuelson; Sanjay Nadkarni; Matt Van Myk; John Ferguson; Jonathan Tibballs; Doris Chan

doi:10.7759/cureus.13459

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

Cureus. 2021 Feb 20;13(2):e13459. doi: 10.7759/cureus.13459.

Authors

Bulang He^{1

2

3}, Duxxa Tailor⁴, Zi Qin Ng⁴, Shaun Samuelson⁵, Sanjay Nadkarni⁵, Matt Van Myk⁵, John Ferguson⁵, Jonathan Tibballs⁵, Doris Chan⁶

Affiliations

¹ Western Australia (WA) Liver and Kidney Transplant Service, Sir Charles Gairdner Hospital, University of Western Australia, Perth, AUS.
² Department Renal Surgery and Transplant, Austin Hospital, Victoria, AUS.
³ Department Renal Surgery and Transplant, Alfred Hospital, Monash University, Prahran, AUS.
⁴ Western Australia (WA) Liver and Kidney Transplant Service, Sir Charles Gairdner Hospital, Perth, AUS.
⁵ Department of Radiology, Sir Charles Gairdner Hospital, Perth, AUS.
⁶ Department of Nephrology, Sir Charles Gairdner Hospital, Perth, AUS.

Abstract

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.

Keywords: arteriovenous fistula; arteriovenous graft fistula; central venous catheter (cvc); flixene graft; haemodialysis access; primary patency rate; secondary patency rate.