Dialysis TransplantationOriginal Article Experience using the Quinton Permcath for haemodialysis in the Irish Republic

Abstract fistula, or in whom there have been multiple failed attempts, need an alternative form of long-term vascu-Background. The Quinton Permcath has been widely used for temporary vascular access in patients requiring lar access. The subclavian percutaneous dialysis cath-eter is widely used for short-term temporary vascularhaemodialysis. Placement under direct vision into the internal jugular vein minimizes the complication rate. access and is generally satisfactory, but complications, principally infection, limit its usefulness. In addition,This access modality is being used more and more for long-term access in the elderly and in patients where the subclavian route is associated with a high incidence of central venous thrombosis [2–4] which may com-other access modalities are unavailable or have failed. Methods. We reviewed the results of 50 central venous promise future fistula or shunt placement in that extremity. For long-term access internal shunts oerPermcaths inserted under direct vision in 61 patients, over a 4-year period. The overall survival and com- the best alternative, but not all patients have suitable vessels.plication rates are estimated. A detailed description of the catheter insertion and removal is provided. Since 1985 we have been using the Permcath (Quinton Instrument Co., Seattle, USA), a double-Results. Seventy-six per cent of patients were success-fully managed using the Permcath for a median dura- lumen silicone rubber dialysis catheter inserted unde