Permacath Insertion

Where do I register?

You may call 706.774.2125 to pre-register if you prefer. Please report to registration on the Heart & Vascular Institute's first floor at your scheduled check-in time.

Where do I park?

Patients and visitors can park in the Heart & Vascular Institute's dedicated flat parking lot off St. Sebastian Way. If you need wheelchair assistance, please park in the main hospital parking deck.

Patient Instructions

  • Be prepared to stay at the hospital three to four hours. The time of your arrival is not the time for your procedure. Arriving earlier does not ensure a shorter wait. The prep time is 45 minutes to one hour. It may be shorter if your physician had all the pre-procedure work-up done, including blood work, EKG, history and physical, and consent form signed for the procedure. We diligently strive to stay on schedule, but a delay in the case ahead of yours or an emergency can increase wait time. On rare occasions you might need to remain in the hospital if the physician decides to continue close observation on you.
  • Follow your physician's instructions on what medications to take. If you are diabetic, ask the office if you should take your medications.
  • Bring a written list of all medications you are currently taking, including insulin, vitamins and herbal preparations.
  • If you are taking the medication Glucophage (Metformin) or a blood thinner (Coumadin or Warfarin), let your doctor know, as the dose may be held or adjusted.
  • Have an adult come to the hospital with you to drive you home if possible. You will be able to drive yourself. Arrange for a responsible adult to help you at home for 24 hours.
  • Wear comfortable clothing.
  • Leave all jewelry and money at home.
  • You may wear your eyeglasses, hearing aids and dentures.
  • Please DO NOT bring small children.

The day of your procedure

Please check in with the registration staff. After the registration process is finished, the CVPR room nurse will transport you to the fifth floor where the CVPR room is located. There is a small waiting room for your visitors to wait during the procedure. You will be asked to disrobe from the waist up and put on a gown. The nurse will apply electrodes to monitor your heart and other equipment to monitor your vital signs. The nurse will have you lie on the table until the physician arrives, and then you will sit up to allow the physician to get to your back to perform the procedure.

The room is typically kept warm but the temperature can be increased and blankets provided as needed. Your family (one to three members) may remain with you until the physician arrives. If more are present, they will be asked to wait in the waiting room just down the hallway from the procedure room.

What happens in a Permacath Insertion?

A Permacath insertion is the placement of a special IV line into the blood vessel in your neck or upper chest just under the collarbone. This type of catheter is used for short-term dialysis treatment. The catheter is then threaded into the right side of your heart (right atrium). The procedure involves creating a tunnel under the skin to thread the other portion of the catheter out through the skin. This tunneling process greatly reduces the risk of an infection and allows the catheter to remain in for a long period of time (one-12 months). The procedure involves complete sterility and the physician, nurse and X-ray tech will wear a mask, sterile gown and lead apron. A nurse will start an IV in your hand or arm and complete the history questionnaire. You will be given sedation through the IV, and the physician will scrub the area on the right or left chest or neck with a Chlorhexadine solution. The physician will ask you to turn your head to the other side while he places a drape over your face and neck to keep the area sterile. The physician will numb your skin with Lidocaine and you will be asked throughout the procedure if you are having any pain. Please tell the nurse or physician and more sedation and pain medication will be given. You will feel some pressure on your neck. The procedure will take 15-45 minutes. After the procedure, a dressing will be applied to cover the insertion site.

What activities can I perform after I go home?

You may resume your normal activities except: Do not shower the day of your procedure or perform heavy activities such as lifting. Do not remove the dressing until you are instructed to do so. You will be able to drive, but it is advisable to have someone to drive you home.

Patient Instructions Post Procedure

PLEASE do not shower or get the catheter wet.

  • You may get into a bathtub, but only get wet to the nipple line (mid-chest).
  • You will need to continue your routine dialysis treatments.
  • Please inform your doctor of any fever or pain, redness or drainage at the catheter site.
  • You may have a small amount of bleeding at the site. Report any bleeding that continues or increases to your physician.
  • You may have mild pain for one to two days. You may take whatever pain medications you use for minor aches and pains.

Frequently Asked Questions

What should I do if the catheter does not work?
If the catheter is not working, the dialysis center will notify your physician to discuss further action or treatment.

How long will the catheter last?
The catheter will last anywhere from one-12 months depending on its care, your freedom from any infections and how long it needs to be used. The catheter is often used while a new graft is healing and as a temporary measure for short term (less than six months dialysis).

Why must the catheter stay dry? What should I do if it gets wet?
Getting the catheter wet greatly increases the risk of an infection at the catheter site by allowing germs to enter or contaminate the catheter. If the catheter becomes wet accidentally, promptly dry it off and cover it with dry sterile gauze dressing (available at any drug store). Notify your physician. Do not apply any antibiotic lotions or other cleaning solutions as they may damage the catheter and/or make it brittle and at higher risk for breaking.

Thank you for choosing Piedmont Augusta.
We hope your experience with us is an excellent one.