Permacath Placement
Reliable long-term vascular access for hemodialysis patients
What is a Permacath?
A Permacath is a specialized tunneled dialysis catheter designed for long-term vascular access in patients requiring hemodialysis. Unlike temporary catheters, it's placed under the skin with a Dacron cuff that helps secure it and prevent infection.
Key Advantages
- •Longevity: 6 months to several years
- •High flow rates (300-400 mL/min)
- •Dual lumen for simultaneous flow
- •Immediate use after placement
Ideal Candidates
- •Patients awaiting AV fistula maturation
- •Those unsuitable for AV fistula/graft
- •Acute kidney failure needing dialysis
- •Bridge to transplant
Permacath Performance Statistics
90%
Technical success rate
85%
1-year functional patency
2.5%
Annual infection rate
*Based on clinical studies of tunneled dialysis catheters
The Permacath Placement Procedure
Pre-Procedure Preparation
Using ultrasound, our vascular specialists map your veins (typically internal jugular or subclavian). The skin is sterilized, and local anesthesia is administered. Prophylactic antibiotics may be given.
Vein Access & Tunneling
Under ultrasound guidance, a needle accesses the vein. A guidewire is placed, and a small tunnel is created under the skin from the vein access site to the exit site (usually on the chest). The catheter is pulled through this tunnel.
Catheter Placement
The catheter tip is advanced to the superior vena cava near the heart. Fluoroscopy confirms optimal positioning. The Dacron cuff sits in the subcutaneous tunnel, promoting tissue ingrowth for stability.
Completion & Dressing
The catheter is secured with sutures at the exit site. A sterile dressing is applied. The procedure typically takes 45-90 minutes, and dialysis can often begin immediately.
Compared to Other Dialysis Access
Permacath Advantages
Immediate Use
No maturation time (vs 6-8 weeks for AV fistula)
Higher Flow Rates
300-400mL/min vs 200-300mL/min for temporary lines
Lower Infection Risk
Tunneling reduces infection by 50% vs non-tunneled
Patient Comfort
Secure placement reduces movement/discomfort
Potential Complications
Infection (2-5%)
Exit site, tunnel, or bloodstream infections
Thrombosis (10-20%)
Catheter malfunction from blood clots
Central Vein Stenosis
Long-term risk with any central catheter
Mechanical Issues
Cracked tubing, dislodgement, or cuff extrusion
Patient Experiences
"After my kidneys failed suddenly, the Permacath allowed me to start dialysis immediately while waiting for my fistula to mature. The placement was quick, and it worked perfectly for my three-times-weekly treatments."
- Robert T., ESRD Patient
"As a elderly patient with weak veins, the Permacath has been my dialysis lifeline for over two years. The nursing team taught me how to care for it, and we've had no major problems."
- Margaret S., Dialysis Patient
Permacath Care Guidelines
Essential Maintenance
- •Dressing Changes: After each dialysis or weekly, using sterile technique
- •Flushing Protocol: Heparin lock after each use (typically 5000 units)
- •Hygiene: Keep dry; use waterproof covers for showers
- •Activity: Avoid heavy lifting; no swimming
When to Seek Help
- •Infection Signs: Fever, chills, redness/swelling at site
- •Flow Problems: Difficulty drawing blood or high pressures
- •Catheter Damage: Cracks, leaks, or dislodgement
- •Respiratory: Sudden chest pain or breathing difficulty
Frequently Asked Questions
How long can a Permacath stay in?
With proper care, Permacaths can function for 6 months to several years. The average lifespan is 12-18 months. They're often used as bridges until AV fistulas mature or transplants occur, but can be long-term solutions when other access isn't possible.
Is Permacath placement painful?
Most patients report only mild discomfort during placement thanks to local anesthesia. Some soreness at the tunnel site may occur for a few days post-procedure, managed with over-the-counter pain relievers.
Can I shower with a Permacath?
Yes, with proper waterproof protection. Use a specialized shower shield or secure plastic covering over the dressing. Never submerge the catheter (no baths/swimming). Change the dressing immediately if it gets wet.
Why choose Permacath over AV fistula?
AV fistulas are preferred for long-term dialysis but require 6-8 weeks to mature. Permacaths provide immediate access and are better for patients with small veins, acute kidney failure, or while awaiting fistula maturation. However, fistulas have lower complication rates long-term.
Need Dialysis Access?
Our vascular access specialists can evaluate which option is best for your treatment needs.
Permacath Fast Facts
Placement Time
45-90 minutes
Vein Options
Right internal jugular (preferred), left IJ, subclavian
Catheter Size
12-14Fr (dual lumen)
Flow Rates
300-400 mL/min (adequate for dialysis)
Removal
Simple outpatient procedure when no longer needed
Who Needs a Permacath?
- •Acute kidney failure requiring dialysis
- •ESRD patients awaiting fistula maturation
- •Failed AV fistula/graft
- •Poor vascular access options
- •Bridge to kidney transplant
Dialysis Emergency?
- •Catheter dislodgement or breakage
- •Severe bleeding at insertion site
- •Sudden chest pain/breathing difficulty
- •High fever with chills