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      Placement of long-term hemodialysis catheter (permcath) in patients with end-stage renal disease through external jugular vein

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          The number of patients with End-Stage Renal Disease (ESRD) has progressively increased in the population. Kidney transplantation is the specific treatment for such patients; however a majority of patients will require hemodialysis before kidney transplantation. The present study aims to investigate using the external jugular vein (EJV) for Permcath placement in these patients.

          Materials and Methods:

          This descriptive and analytical study was conducted in Alzahra Medical Center, Isfahan, in 2012. Catheters were inserted by cutting down the right EJV. The patency rate and potential complications were studied. The obtained data was analyzed using SPSS 21.0.


          Out of 45 live patients, within three months of surgery, 40 patients (81.6%) had no complications and dialysis continued through Permcath. Permcath Thrombosis occurred in two patients (4.4%). Catheter infection led to the removal of it in one patient (2.2%) 1.5 months after surgery. And accidental catheter removal occurred in one patient.


          Placement of the permcath in the external jugular vein can be a safe, uncomplicated, and reliable method for patients requiring hemodialysis, and can be a life-saving alternative in patients without accessible internal jugular vein.

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          Most cited references 18

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          Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula.

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            Central venous catheter use. Part 1: mechanical complications.

            Central venous catheters are being increasingly used in both intensive care units and general wards. Their use is associated with both mechanical and infectious complications. This review will focus on short- and medium-term mechanical complications of catheter placement; infectious complications will be discussed in a separate article. The most important risk factors are patient characteristics (morbidity, underlying disease and local anatomy), the expertise of the doctor performing the procedure, and nursing care. Placement aids, such as ultrasound-guided catheter insertion, are also discussed.
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              Post catheterisation vein stenosis in haemodialysis: comparative angiographic study of 50 subclavian and 50 internal jugular accesses.

              From January 1986 to December 1990 we studied angiographically the subclavian-brachiocephalic vein of 100 patients dialysed by subclavian catheter for 50 (first group) and by internal jugular catheter for the 50 others (second group). These two groups were not statistically different as regards age (61.6 +/- 11.3 years in the first and 61 +/- 11.1 in the second), sex (48% and 56% were women), duration of catheter insertion (31 +/- 21.8 and 31.7 +/- 16 days), and the number of dialysis sessions (13.5 +/- 9.1 and 13.6 +/- 7.1). The type of catheters, the frequency of removal for poor flow (16% in both groups) or infections (6% in both groups), and the local nursing were similar in the two groups. The only difference was the side of cannulation: the right side in 58% of cases in group 1 and 78% in group 2. The angiographic study revealed a stenosis of the vein in 42% of the subclavian group and in 10% of the internal jugular group: a dramatic difference in favour of the internal jugular route, whose superiority over the subclavian route is asserted in respect of venous access of dialysed patients.

                Author and article information

                Adv Biomed Res
                Adv Biomed Res
                Advanced Biomedical Research
                Medknow Publications & Media Pvt Ltd (India )
                06 December 2014
                : 3
                Department of Vascular Surgery, Isfahan University of Medical Sciences, Alzahra Hospital, Isfahan, Iran
                [1 ]Department of Surgery, Isfahan University of Medical Sciences, Alzahra Hospital, Isfahan, Iran
                [2 ]Department of Cardiology, Isfahan University of Medical Sciences, Alzahra Hospital, Isfahan, Iran
                Author notes
                Address for correspondence: Dr. Ali Sharifi, Alzahra Hospital, Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: Sharifi331@
                Copyright: © 2014 Beigi.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Original Article

                Molecular medicine

                access, patients with end-stage renal disease, permcath


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