A Permacath, also known as a tunneled catheter or cuffed catheter, is a type of vascular access device used for hemodialysis in individuals with kidney failure. It is a long-term catheter inserted into a large vein, usually the internal jugular or subclavian vein, and tunnelled under the skin to exit the body. The Permacath has two lumens, allowing blood to be withdrawn from the patient, filtered through the dialysis machine, and then returned to the patient.
The insertion procedure involves making a small incision for the tunnel and another for the catheter insertion. It is typically performed under local anesthesia. The catheter is secured in place with a cuff, which promotes tissue adherence and helps prevent infection. After insertion, the patient usually needs to wait for a period of healing before using the catheter for dialysis.
This type of catheter is used when other forms of vascular access, such as fistulas or grafts, are not suitable or have failed. While Permacaths provide a reliable means for hemodialysis, they are associated with a higher risk of infection and other complications compared to arteriovenous fistulas, which are considered the preferred long-term access for dialysis. The choice of vascular access depends on individual patient factors and clinical considerations.