title: Use of the Flixene vascular access graft as an early cannulation solution.
abstract: 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.
authors.affiliation: Faculté de Médecine, Université Bordeaux, Bordeaux, France; Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France. Electronic address: xavier.berard@chu-bordeaux.fr.
authors.forename: Xavier
authors.initials: X
authors.lastname: Berard
authors.affiliation: Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ottaviani
authors.affiliation: Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Brizzi
authors.affiliation: Vascular Surgery Department, CHUV de Lausanne, Lausanne, Switzerland.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Deglise
authors.affiliation: Nephrology Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: de Precigout
authors.affiliation: Faculté de Médecine, Université Bordeaux, Bordeaux, France; Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Ducasse
authors.affiliation: Faculté de Médecine, Université Bordeaux, Bordeaux, France; Nephrology Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Combe
authors.affiliation: Faculté de Médecine, Université Bordeaux, Bordeaux, France; Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Midy
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D005602:France; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D006435:Renal Dialysis; D012086:Reoperation; D013848:Thigh / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency