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Early cannulation of the Flixene™ arteriovenous graft
Nicolas Ottaviani1,2, Sébastien Deglise3, Vincenzo Brizzi1
1Vascular Surgery Department, CHU de Bordeaux, Bordeaux - France.
Insights
Early cannulation of Flixene™ arteriovenous grafts (AVGs) within 3 days is effective. This approach shows comparable patency and complication rates to traditional grafts, which require delayed cannulation.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- Arteriovenous grafts (AVGs) are crucial for hemodialysis access.
- Traditional AVG cannulation requires a 2-week waiting period.
- Optimizing AVG utilization is essential for patient care.
Purpose of the Study:
- To evaluate the efficacy of early cannulation for Flixene™ AVGs.
- To assess patency and complication rates associated with early AVG use.
- To compare Flixene™ graft outcomes with conventional grafts.
Main Methods:
- Systematic literature search across major databases (PubMed, Medline, Embase, Cochrane).
- Inclusion of six studies with 260 procedures.
- Primary outcomes: time to first cannulation and 12-month patency; Secondary outcomes: complication rates.
Main Results:
- Median time to first cannulation for Flixene™ grafts was under 3 days.
- 12-month secondary patency rates ranged from 63% to 92%.
- Complication rates (infection, pseudoaneurysm) were comparable to traditional grafts.
Conclusions:
- Early cannulation (within 3 days) of Flixene™ AVGs is feasible.
- Flixene™ grafts demonstrate equivalent 12-month patency and complication rates to conventional grafts.
- Early cannulation may improve AVG access efficiency without compromising safety.
Purpose:
The aim of this review was to search for evidence of the efficiency of early cannulation of the Flixene™ (Maquet-Atrium Medical, Hudson, NH, USA) arteriovenous graft (AVG) in the current literature and to assess its patency and complication rates.
Methods:
Searches in Pubmed, Medline, Embase and the Cochrane Library were performed using the following specific search terms: early cannulation AVG and/or Flixene™ graft. The primary outcomes were mean time to first cannulation and patency rates at 12 months. Secondary outcomes were complications.
Results:
Six studies reporting outcomes in a total of 260 procedures were included in this review. The median delay from intervention to first cannulation was documented in four studies and was less than 3 days. Primary assisted patency at 12 months ranged from 45% to 53% in the four documented series. In five studies, documented secondary patency at 12 months ranged from 63% to 92%. Two studies compared outcomes between traditional and Flixene™ grafts: one study reported significantly (p<0.01) improved one-year patency using the Flixene™ graft, the two studies did not report significant differences in complication rates between both groups. The rate of infection and pseudo-aneurysm formation ranged from 0 to 11% and 0 to 6%, respectively.
Conclusions:
This review shows that early cannulation of the Flixene™ graft within 3 days following its implantation is feasible with one-year patency and complication rates equivalent to those of conventional grafts which can be cannulated only after 2 weeks.
