Five years experience with the Quinton Permcath for vascular access

Area of Science:

• Nephrology
• Vascular Surgery
• Medical Devices

Background:

• Dialysis patients often require long-term vascular access.
• Traditional access methods may be unsuitable for certain patient groups.
• The Quinton Permcath is a type of central venous catheter for dialysis.

Purpose of the Study:

• To evaluate the efficacy and safety of the Quinton Permcath for long-term hemodialysis access.
• To assess catheter survival rates and complication profiles in a cohort of dialysis patients.

Main Methods:

• A retrospective analysis of 64 Quinton Permcath insertions in 51 dialysis patients over five years.
• Data collected included patient demographics, indications for use, catheter dwell time, survival rates, and complications.
• Complications analyzed included insertion-related issues, exit site infections, sepsis, thrombosis, and flow problems.

Main Results:

• Actuarial catheter survival rates at 1, 2, 3, and 4 years were 74%, 43%, 25%, and 12%, respectively.
• Common indications included exhausted peripheral access and contraindications to other methods.
• Minor insertion complications occurred; exit site infection and sepsis rates were 4.95 and 3.36 per 1000 catheter days.
• Catheter failure due to infection occurred in 18 cases; flow difficulties in six.
• Catheter sepsis contributed to two patient deaths; one subclavian/innominate vein thrombosis was noted.

Conclusions:

• The Quinton Permcath provides immediate, durable, and relatively safe vascular access for dialysis.
• It is a valuable option for patients facing difficult or contraindicated conventional access methods.
• Careful monitoring is necessary to manage infection and thrombosis risks associated with long-term use.