Clinical Evaluation of Use of Permcath(R) in Patients with Poor Vascular Access / 대한신장학회잡지

ABSTRACT

Permanent vascular access is a prerequisite for successful treatment of patients with chronic hemodialysis. Although a number of strategies including native and synthetic arterio-venous fistulae are performed to create vascular access, they are often not available due to peripheral vascular diseases which are common in patients with diabetes and elderly patients. So, in spite of technical advance, vascular access for hemodialysis remains a significant problem confronting the nephrologists. Recently, Permcath(R) (double lumen silicone rubber catheter) has been introduced and can provide temporary access in patients whose native fistulas have not yet matured and permanent access in patients who have difficulty in creating a arterio-venous fistula. We investigated the availability and the clinical outcome of use of Permcath(R) as temporary or permanent vascular access. Total 16 catheters were placed in 14 patients who were admitted in Chung-Ang University Hospital between April, 1993 to March, 1996. Clinical course of the patients and outcome of the catheters were observed, retrospectively. The mean age of the 14 patients was 56 9 (39-67) years. The indications were exhausted peripheral access, poor vascular system for conventional access operation, and limited life expectancy. The median survival of the catheters was 80 weeks with a range of one week to 113 weeks. The one-year actuarial catheter survival rate was 67% and 44% at 2 year. The most common complication during use of Permcath(R) was infection, occurred in 5 patients (31.2%). The 5 catheters were removed because of complications of catheter such as infection or malfunction. We suggest that the Permcath(R) is a safe and durable temporary vascular access for patients with poor vascular system anticipating a long duration for arterio-venous fistula maturation and permanent access for patients who have exhausted peripheral access sites.