What is a Permcath?

Permcath is a piece of long, thin, flexible tube with two hollow bores, which is inserted into a vein. It is mostly inserted in the internal jugular vein in the neck and less commonly in the femoral vein in the groin area. One hallow bore will carry the blood from the body to the dialysis machine and other part will carry the blood from dialysis machine to the body. The permcath, having a cuff will hold the catheter in place and protect from infections by acting as a barrier.

How is it done?

Before the procedure

  • Do not drink or eat anything at least 4 hours before the procedure.
  • Inform the doctor about all ongoing medications especially if on blood thinners.
  • Inform the doctor about any allergies to any medications or any infections experienced in the past.
  • Wear comfortable clothes and leave all valuable things and jewelry at home.
  • Don’t wear dentures, hearing aids and eyeglasses during the procedure.  
  • The patient should undergo some blood tests, physical examination test and Doppler scan before the permcath insertion.

During the procedure

  • A small, thin, flexible tube called IV cannula will be placed in the back of the hand to deliver the drugs directly into the vein. 
  • The patient will be made to lie flat and sedatives will be administered intravenously for relaxing the body and relieve any pain until the procedure is completed.
  • Antiseptic solution or sterile solution will be used to rub the zone where the catheter is to be inserted.
  • The doctor will place a clip on one of the finger to record the oxygen levels in the blood.
  • Once the patient is sedated, the doctor will guide a wire into the superior venacava or right atrium of the heart through the external jugular vein. By this way, the doctor will create a tunnel and guide the catheter in to the right atrium of the heart. The cuff will help to keep the catheter in place which is present under the chest wall. The place where the catheter leaves the chest wall will be stitched and transparent dressing will be employed on the stiches.
  • The stiches and dressing will keep the catheter in its position. The stiches and dressing will be removed after 10 days.
  • An X-ray imaging tests will also be conducted after the insertion of permcath to confirm the position of permcath.

The procedure last for about 45 minutes.

What precautions need to be taken after the procedure?

  • Don’t lift weights heavier than 5kgs
  • Do not wet the catheter/dressing during baths. 
  • Inform the doctor if symptoms like pain or fever, discharge or redness appear at the catheter site.
  • 4. Inform the doctor if any bleeding occurs at the site.
  • 5. Do not indulge in any vigorous activities like contact sports and swimming.
  • 6. Dressing over the site should be clean and dry so that it will hold the catheter in place and less prone to infections.

What are the advantages of Permcath?

  • Permcath is less prone to infection
  • It remains in the body longer than temporary jugular catheter.

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Dr. Ajay Shetty.

Senior Consultant - Urology & Andrology

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