Publication: Permcath - A Vascular Access for Hemodialysis, Our Experience in Last Two Years
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The double lumen tunneled catheter (Permcath) is mostly used as an alternative
access, not as a temporary access in End Stage Renal Disease patients requiring
hemodialysis. If there is no possibility of other access modalities, failed or unable to
create native arteriovenous fistula (AVF), Permcath can be a very good alternative.
Objective
To find the indications, complications and results of Permcath insertion.
Method
We reviewed the results of 92 Permcath inserted under ultrasound guidance in two
different hospitals, 45 in Sahid Dharma Bhakta National Transplant Center (SDNTC),
Bhaktapur and 47 in Nidan Hospital Pvt. Ltd., Lalitpur from April 2016 to April 2018
retrospectively.
Result
We had inserted 55 Permcath (59.78%) in right internal jugular vein (IJV), 25 (27.17%)
in left internal jugular vein and 12(13.04%) in femoral vein. In terms of major
complications, two (2.17%) patients had profound hypotension, bradycardia and
cardiac arrest due to left internal jugular vein tear. Three patients (3.26%) died within
a week due to septicemia and 23 patients (25%) died with multiple causes within
one year. Of the cases, till now in 39 cases (42.39%) Permcath has been removed.
Major reasons of removal of Permcath are post renal transplant in 18 cases (19.57%),
Arterio Venous Fistula maturation in 13 cases (14.13%), Infection in six patients
(6.52%) and non functioning Permcath in two patients (2.17%).
Conclusion
Permcath remains a reliable method for short term vascular access, hence can be
used as a bridge to renal transplant or arteriovenous fistula maturation.
KEY WORDS
Permcath, Tunneled dialysis catheter, Vascular access
Description
Baidya PR,1 Shrestha K,2 Deuja ML,3 Rai A,3 Shrestha N,3 Shrestha A,4 Baidya A5
1Department of Cardiothoracic and Vascular Surgery,
2Department of Nephrology,
3Department of Anesthesia,
Sahid Dharma Bhakta National Transplant Center,
Bhaktapur, Nepal.
4Department of Anesthesia, Nidan Hospital,
Pulchowk, Nepal.
5Intern, Nepal Medical College
Jorpati, Kathmandu.
Keywords
Permcath, Tunneled dialysis catheter, Vascular access