What is a Permcath?

Permcath is a 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 hollow bore will carry the blood from the body to the dialysis machine, and the other part will carry the blood from the 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, a physical examination test and a Doppler scan before the permcath insertion.

During the procedure

• A small, thin, flexible tube called an 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 to relax the body and relieve any pain until the procedure is completed.
• An 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 fingers to record the oxygen levels in the blood.
• Once the patient is sedated, the doctor will guide a wire into the superior vena cava or right atrium of the heart through the external jugular vein. In this way, the doctor will create a tunnel and guide the catheter into 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 a transparent dressing will be employed on the stitches.
• The stitches and dressing will keep the catheter in its position. The stitches and dressing will be removed after 10 days.
• An X-ray imaging test will also be conducted after the insertion of the permcath to confirm the position of the permcath.

The procedure lasts for about 45 minutes.

What precautions need to be taken after the procedure?

• Don’t lift weights heavier than 5 kgs
• 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.
• Inform the doctor if any bleeding occurs at the site.
• Do not indulge in any vigorous activities like contact sports and swimming.
• 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 a temporary jugular catheter.