Tunnelled catheters (Permcath)

A tunneled dialysis catheter is a type of catheter used in hemodialysis for patients who
require long-term vascular access. It is a thin, flexible tube that is inserted through the skin
and tunneled under the subcutaneous tissue to enter a central vein, usually the jugular vein,
in the neck. The catheter is then threaded down into the superior vena cava, which is a large
vein that leads directly to the heart.

Tunneled dialysis catheters are used when other types of vascular access, such as
arteriovenous fistulas or grafts, are not possible or have failed. They are typically used for a
few weeks to a few months until a more permanent form of access can be established.

The procedure to insert a tunneled dialysis catheter is typically performed under local
anesthesia and sedation, and takes about 30-60 minutes. After the catheter is inserted, it is
secured in place with sutures and a dressing is applied to the site.

To prevent infection, patients with a tunneled dialysis catheter must take special care to
keep the site clean and dry, and should avoid activities that could dislodge or damage the
catheter. They should also avoid exposing the catheter to water, such as during swimming
or bathing.

Although tunneled dialysis catheters are effective for providing temporary vascular access,
they carry a risk of complications, such as infection, bleeding, or clotting. Patients who
require long-term dialysis should discuss their options for permanent vascular access with
their healthcare team.