Kidney Week

Abstract: TH-PO295

Permcath Survival: A 3-Year Retrospective Study in a Tertiary Hospital

Session Information

• Vascular Access: From Biology to Managing Complications
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Vascular Access

Authors

• Piggott, Raymond Simon, Mater Misericordiae University Hospital, Dublin, Ireland

Raymond Simon Piggott,

• Redahan, Lynn, Mater Misericordiae University Hospital, Dublin, Ireland

Lynn Redahan,

• O'Meara, Yvonne M., Mater Misericordiae University Hospital, Dublin, Ireland

Yvonne M. O'Meara,

• Sadlier, Denise M., Mater Misericordiae University Hospital, Dublin, Ireland

Denise M. Sadlier,

Background

Arterio-venous fistula (AVF) are the preferred access for patient’s requiring chronic intermittent haemodialysis. However, permanent dialysis catheters (permcaths) are frequently used as an alternative access. In this retrospective study the indications, complications and outcomes of permcath insertion were studied in a single tertiary centre.

Methods

Using the electronic medical record and interventional radiology database, all patients who underwent a permcath placement were examined from 1^st January 2020 to 31^st March 2022. In addition to demographic information, data with regard to subsequent permcath removal, exchange and outcome was obtained. Any patient undergoing permcath placement for any other purpose other than intermittent haemodialysis were excluded from the study. Data with regard to whether the patient had been referred and/or undergone AVF fistula or other vascular access formation was also reviewed. Permcath removal was defined as no further need of permcath while permcath exchange was defined as temporary removal and/or direct exchange due to malfunction and/or sepsis. All data recorded was done so in compliance with data protection legislation.

Results

118 patients underwent permcath placement placed during this time, age range 18–90 years (median age = 63 years), male: female 58%:42%, average Kt/V >1.78/week and average blood flow 300 ml/min. The average life span of a removed permcath was 197 days (range = 7–819 days). 37 permcaths were removed: 45% (n = 17) due to renal recovery, 30% (n = 11) due to successful AVF placement, 2% (n = 1) transitioned to peritoneal dialysis and 18% (n = 3) underwent successful renal transplantation. 32 permcaths were exchanged: 19% (n = 6) were due to sepsis, 6 patients required more than one permcath exchange (range 2–5 exchanges) due to blocked permcath, permcath dislodgement, exposed cuff and inadequate flows. In all of these patients there was no alternative access.

Conclusion

Permcaths are a reliable method of vascular access but their utility is often impeded by complications and a relatively short lifespan. They should not replace AVFs as the preferred haemodialysis access