What is a permacath and why do I need one?

A permacath is a piece of plastic tubing – very similar to a jugular catheter – and is used inexactly the same way for your haemodialysis. The permacath has a cuff that holds the catheter in place and acts as a barrier to infection. Thecuff is underneath the skin and cannot be seen. The catheter part that you can see is the partthat protrudes from the chest wall. It is about 6 inches/15cms long and is made of soft, white, flexible plastic. There are 2 limbs. A transparent dressing will be put over the part where the catheter leaves the chest wall and(since the catheter is under the level of your collar bone) it will not be seen when you areclothed.

Where is the permacath placed?

The permacath is placed in the jugular vein. It is tunnelled under the skin and tissues along theupper chest, under your collar bone and the end of the catheter will come out on the chest wall,about 4 inches/10cms underneath the collar bone. As the permacath is less prone to infection, it can remain in your body for longer than thejugular catheter, whilst you are waiting for a fistula to be inserted. Occasionally, it is used forlonger if a fistula cannot be formed. However, infections can occur in the permacath and itsometimes needs to be replaced.

PERMCATH INSERTION PROCEDURE

Dialysis is the lifeline of Chronic Kidney diseases [CKD] / Renal failure patients. AV Fistual is the most common dialysis access method. If it fails or can’t be done then Permcath placement is 2nd preferred method of long term Hemodialysis. A flexible tube which is inserted into vein having 2 hollow bores is called as Permcath. Generally Permcath is inserted in internal jugular vein and very rarely in femoral vein in the groin region. One hollow bore carries blood from body to dialysis machine whereas the other bore carries blood from dialysis machine to body. There’s a cuff which holds catheter in place protecting from infections which also acts like a barrier.

BEFORE THE PROCEDURE

• Patient is kept in NBM for 5-6 hours before the procedure.
• If the patient is already on blood thinners or any particular medicines or allergic to any medicines, infections in past then the doctor should be reported about the same.
• Patient should undergo physical examination test, blood tests and colour Doppler test before the procedure.

DURING THE PROCEDURE

A flexible tube called as IV Cannula is inserted into back side of the hand inorder to deliver drugs directly into the vein. Patient is asked to lie flat on the bed thereby sedatives are administered intravenously to relax the body and relieve any pain till the procedure is completed. Antiseptic solution or sterile is rubbed at body region wherein catheter is to be inserted. Doctor records oxygen level in the blood. After sedating the patient doctor will guide a wire into the superior venacava or right atrium of heart through internal jugular vein. In this way doctor creates the tunnel and thereby guides the catheter into the right atrium of the heart. Cuff keeps the catheter in place or holds it in place which is present under the chest wall. The region where catheter leaves chest wall is stitched and transparent dressing is applied over the stitched area. Cathlab Imaging tests are conducted after the permcath insertion inorder to confirm the Permcath position. This procedure lasts for approximately 45-50 mins. The advantages of Permcath are like it is less prone to infection and moreover it lasts for much longer duration than jugular catheter. We are known as “Centre for Excellence in Vascular &; Interventional Radiology”. At 7 Orange Hospital we have Dr Kiran Naiknaware – Interventional Radiologist, Endovascular specialist who uses least invasive method for Varicose Veins and Thread Veins removal treatment for your legs. We offer Foam Sclerotherapy &; Endovenous Laser Ablation procedures to remove Varicose veins. He has done more than 400 Permcath procedures thereby giving better treatment to patients for their future living.