PERM CATHETER
A perm catheter is a small, flexible tube that is surgically placed under the skin to provide long-lasting access to a person’s blood vessels.
perm dialysis catheter is used for people who need frequently hemodialysis treatments to filter waste water and excess waste from the blood when kidney is not working.
One end of hemodialysis perm catheteris inserted into a large vein, in chest area and other end stay outside of skin.
In perm catheter for dialysis, blood is removed from the body through the perm catheter, filter by dialysis machine and clean blood returned to body through same catheter.
Temporary dialysis catheters are frequently replaced, a perm catheter is designed to remain in place under the skin for several months or longer. It allows easy access to vascular for each dialysis without repeatedly inserting new catheters.
Having permanent catheters make dialysis treatment easy and comfortable for patient.
TYPES OF PERM CATHETERS:
Tunneled Cuffed Catheter
- It’s the most common type used for long term dialysis access.
- hemodialysis perm catheter has a longer tubing portion which goes inside the skin before entering a large vein, chest area.
- There is a cuff portion that help it to hold on a place and allow tissue to grow around it.
Non-Tunneled Catheter
- It is a straight catheter which goes directly into vein without being tunnelled under the skin.
- Its main use is for temporary dialysis access.
- As it doesn’t have a cuffed portion, there is more chances of infection.
Catheter Port or Implanted port
- It involves surgical implanting a small reservoir or port under the skin.
- During hemodialysis perm catheter, needles are inserted through the skin into the port to access the blood stream.
- The port has a catheter that connects to a large vein.
ALTERNATIVES TO PERM CATHETERS FOR DIALYSIS:
Arteriovenous fistulas (AVFs)
- It is created by joining an artery and vein, in the arm during minor surgery.
- It allows the vein to become larger and stronger to withstand for repeatedly needle insertion for dialysis.
- AVFs are preferred over catheters as they have lower infection risk and tend to last longer.
- It takes several months for AVF to develop fully.
Arteriovenous Grafts (AVGs)
- If patient’s vein is too small for an AVfs then a synthetic graft tube is used to join artery and vein.
- Like AVFs, AVGs also allow needles to insert for dialysis with lower infection risk.
- Grafts not last longer as fistulas but ready for use sooner being placed.
Peritoneal Dialysis (PD) Catheter
- PD catheter is surgically placed through the abdomen into the peritoneal cavity.
- Dialysis solution is cycled into and out of abdomen through this catheter to filter waste from blood.
USES OF PERM CATHETERS:
- Vascular access for hemodialysis treatments-Main use of perm catheter for dialysis is to provide long lasting access to a person’s bloodstream during hemodialysis sessions.
- Bridge to other permanent access- perm dialysis catheter is used as a temporary access for a patient waiting for permanent vascular access.
- Lack of viable vascular sites – Some dialysis patients are not suitable for other permanent access. In this case, a hemodialysis perm catheter provides option for long-term vascular access.
- Emergency dialysis access- If patient need urgent dialysis access and do not have mature access site ready, then a perm Cather can be quickly inserted to start dialysis until permanent solution is established.
- Long-term dialysis for some patients- It’s not ideal for long-term, perm dialysis catheter may only viable access option for certain high risk dialysis patient who are unable to get permanent access due to their health condition.
BENEFITS OF PERM CATHETER:
- Convenient Vascular access:perm catheter provides easy access to bloodstream for hemodialysis treatment.
- Immediate use: perm dialysis cathetercan be used for dialysis right after insertion, It is useful in urgent situation.
- Long-term access option: For patients who lack suitable veins or are high risk for other access types, a perm catheter may be the only long-lasting vascular access solution available.
- Avoids repeated needle sticks- With the help of hemodialysis perm catheter, patients don’t have to get multiple sticks into their veins for dialysis treatment, which can cause pain and difficulty.
- Allows uninterrupted dialysis – If a patient’s other vascular access fails, a perm dialysis cathetercan help to continue receiving life-saving dialysis treatment without interruption.
- Potential for better blood flow- some perm catheter for dialysis is designed with larger lumens or multiple tubes, providing better flow rates during hemodialysis.
COST OF PERM CATHETERS:
At government hospital, perm catheter for dialysis price are generally low. Basic tunneled dialysis perm catheter price is around Rs. 3,000 to Rs. 8,000.
At private hospital, perm catheter for dialysis price is higher. A tunneled perm catheter from a major brand can cost around Rs. 10,000 to Rs. 30,000 or more.
Special catheters with additional features like antimicrobial coatings, this type of perm catheter price is around Rs. 40,000.
BRANDS:
- Mahurkar Catheters (Coviden / Medtronic) – It is earliest and most widely used tunneled dialysis catheters. It is available in different lumen sizes. It is made up of silicon or polyurethane materials.
- Palindrome Catheters (Angio dynamics) – It is designed with a curved tip to improve blood flow. It has antimicrobial coating to reduce infection. It comes in chronic (long-term) and acute (Temporary) version.
- Hemo-cath Catheters- It offers split -tip design to separate blood inflow and outflow. It is made up of kink-resistant polyurethane. It is available in different French sizes and lumen configuration.
- Life Cath Catheters (Spiritus Medical) – It offers unique spiral tip design to reduce clotting and improve flow. Comes with pre-loaded insertion kit for easier placement.
FREQUENTLY ASKED QUESTIONS:
Q. What is a perm catheter?
Ans. It is a long-lasting tube that is placed surgically under the skin to provide access to the blood stream for hemodialysis treatment.
Q. How long a perm dialysis catheter stays?
Ans. It is designed to remain in place for several month or even years.
Q. Are perm catheters safe for long -term dialysis use?
Ans. No, it carries a higher risk of infections and clotting. For longer term safety proper care and monitoring are essential.
Q. How is a perm catheter for dialysis inserted?
Ans. It is surgically implanted in chest area, with the catheter portion tunnelled under the skin and inserted into a large vein like the jugular or subclavian vein.
Q. Can I shower or swim with a perm dialysis catheter?
Ans. Showering is generally allowed, but the catheter exit site must be cleaned and dry, Swimming or soaking in water is usually not recommended due to infection risk.
Q. When should a perm dialysis catheter be removed?
Ans. It may need removal if noticed like infections or clotting occur, or if the catheter is no longer needed for dialysis.
Q. Are there alternatives to prem catheters for dialysis?
Ans. Yes, alternatives include arteriovenous fistulas (AVFs), arteriovenous grafts (AVGs) and peritoneal dialysis catheters.
