Learn all about Permacath catheter, its placement procedure, and all the benefits related to Permacath and its risks. According to radiologists Permacath catheter is inserted into the large central veins of the chest or upper arm to get rid of regular hemodialysis. A Permacath can provide access to the vascular system for a year, or it can be used as a point of permanent access.
Regular hemodialysis to treat kidney failure, repeated blood draws or long-term infusions of medication can make it difficult to access the vascular system through the veins. This activity can make the veins and surrounding tissue painful and it can even damage the veins.
A Permacath is a catheter placed through a vein into or near your right atrium. Your right atrium is the right upper chamber of your heart. A Permacath is used for dialysis in an emergency or until a long-term device is ready to use. After your procedure, you will have some pain and swelling on your chest and neck.
The Permacath will have a kind of cuff attached that will help secure the catheter. Scar tissue builds up around the cuff which helps keep it in place and prevent infection. No one will be able to see the cuff which is under the skin. The visible portion of the catheter is a single catheter exiting the chest wall with two extensions. The radiologist will use very small instruments to put the Permacath in place. The Permacath is larger than most catheters. There may be an X-ray machine used before, during or after treatment.
Dialysis patients using catheters have a higher risk for death, infection and heart problems than patients using other procedures to access the blood, according to a new analysis. With a Permacath inserted, you have to be extra careful and avoid vigorous activities like swimming. Make sure that the dressing over the sites is always clean and dry. A small shower is always preferred to a bath in which the dressing soaks. The dressing should always be dry and secure, so that it holds the catheter in position firmly and the risk of infection is reduced.
Permacath Catheter Placement Procedure
In Permacath placement procedure first of all general anesthesia is given to patients to keep them asleep and free from pain during the procedure. Sometimes local anesthesia may be given to numb the area. With local anesthesia, patient may still feel pressure or pushing during the procedure, but should not feel any pain. Sometimes local anesthesia may be given to relax the patient by the healthcare provider. Then an incision is made on the chest. And the second incision is made on neck near the jugular vein. This will help to direct the catheter.
After this the catheter is tunneled under the skin on the right side of chest. The catheter will be moved forward into the internal jugular vein. Then, it is moved forward until it is in or near the right atrium. An ultrasound or x-ray may be used to help guide placement of the catheter. Stitches will be placed to hold the catheter in place. The catheter will have 2 ports on the end. One port will be red and the other will be blue. A clear dressing will be placed over the catheter and the area where it goes into the skin. The ports will not be covered.
Permacath catheter Benefits, Risks
The benefits of having a Permacath inserted include:
- You will not have to have an IV placed every time you need medication such as chemotherapy
- It will allow kidney hemodialysis when there is no other access to your vascular system
- Catheters are very helpful to patients in many different situations and are used for draining urine from the bladder when a patient is not able to do so on their own or when a medical professional feels it is necessary
Permacath Catheter Risks
- Permacath catheter insertion may lead to some kind of risks, as with any operation and anaesthetic there are risks involved but these are small.
- When the Permacath is inserted there is a chance that bleeding could occur or that an infection could develop
- Thrombosis: formation of a blood clot in the catheter may block the device irrevocably. To prevent clotting the portacath is flushed with saline and heparin, usually by a nurse or other medical professional, or someone properly trained that is a family member or the patient, at least once every four weeks, or more often in conjunction with administering medication.
- Pneumothorax: Attempts to gain access to the subclavian vein or jugular vein can injure the lung, potentially causing a pneumothorax. If the pneumothorax is large enough, a chest tube might need to be placed. In experienced hands, the incidence of this complication is about 1% when accessing the subclavian vein. When accessing the jugular vein the pneumothorax rate is virtually nonexistent.