Inferior Vena Cava Filter Placement

(Inferior Vena Cava Filter Removal; IVC Filter Placement; IVC Filter Removal)

In-fer-e-or Ve-na Cah-va Fill-tore Plas-ment and Re-mov-ul

Definition

The inferior vena cava (IVC) is a large vein that collects blood from the lower body and delivers it to the heart. An IVC filter is a small, cone-shaped device that is placed in the IVC to catch blood clots before they reach the heart.

Blood Flow Through the Heart

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Reasons for Procedure    TOP

Blood clots can develop in the veins of the leg. Occasionally, these blood clots can travel through blood vessels of the legs, to the IVC, then to the heart and lungs. If the clot is large enough it can create a blockage in the arteries of the lungs and cause difficulty breathing, chest pain, or death. Conditions that increase the risk of a traveling blood clot include:

Deep Vein Thrombosis

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An IVC filter can catch blood clots from the legs before they reach the heart and lungs. Because the IVC is such a large blood vessel, the filter can catch the blood clot without blocking blood flow. Over time the blood clot will break apart.

This procedure is often used in people who have a high risk for developing blood clots but cannot take blood thinning medications.

Possible Complications     TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Adverse reaction to anesthesia or x-ray dye such as lightheadedness, low blood pressure, or wheezing
  • Excess bleeding
  • Damage to the IVC
  • The IVC filter moves from its proper position after surgery
  • Pulmonary embolism from broken IVC filter pieces
  • Injury to the neck or groin due to catheter insertion
  • Infection
  • Heart attack
  • Soreness in throat
  • Nausea and vomiting
  • Blood clots—rarely, some blood clots can be caused by the IVC filter
  • Blood clots pass the filter—rare

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity

What to Expect    TOP

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Blood tests
  • Electrocardiogram (EKG)—a test to record the heart’s activity by measuring electrical currents through the heart muscle
  • Imaging tests

In the days leading up to your procedure:

  • Certain medications may need to be stopped up to one week before the procedure. Talk to your doctor before the procedure about all medications you are taking.
  • Arrange for a ride to and from the procedure. Also arrange for help at home after the procedure.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.
  • You may be asked to shower before your procedure. You may be given special antibacterial soap to use.
  • If you smoke, talk to your doctor about ways to quit. Smoking may slow your recovery.

Anesthesia

A local anesthetic will be used to numb the area where the catheter (tube) will be inserted. This is usually in the groin or the neck. You will be awake during the procedure.

You may also be given a sedative to help you relax.

Description of the Procedure     TOP

A small incision will be made in your groin or neck. A catheter will be passed through this incision into a major blood vessel until it reaches the IVC. Imaging and contrast dye will be used to help your doctor see the catheter as it passes through your blood vessels. You may feel a flush when the contrast dye is injected. A collapsed IVC filter will be delivered through the catheter to the desired location. Once in place, the filter will be opened. The catheter is then removed. Pressure will be applied to the insertion site for about 10 minutes after the procedure to prevent bleeding. A bandage is placed over the incision.

Immediately After Procedure     TOP

After the operation, you will be taken to the recovery room for observation.

How Long Will It Take?     TOP

About 1 hour

How Much Will It Hurt?     TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay     TOP

You will usually go home the same day. If you have any problems, you may need to stay longer.

Post-procedure Care    TOP

At the Hospital

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Medication to help manage pain or prevent blood clots may also be given.

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions

At Home

It will take some time for full recovery with a gradual return to normal activity levels in about 2 days. To help your recovery:

  • Avoid smoking.
  • Eat a heart-healthy diet that is low in fat and cholesterol.
  • Exercise as advised by your doctor.
  • Be sure to follow your doctor’s instructions.

Some IVC filters may be removed when they are no longer needed.

Call Your Doctor     TOP

Call your doctor if any of these occur:

  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the catheter insertion site
  • Pain that you cannot control with the medications you have been given
  • Nausea and vomiting
  • Chest pain
  • Signs of infection, including fever and chills
  • Cough, shortness of breath, or chest pain
  • Your legs become blue and cold

If you think you have an emergency, call for emergency medical services right away.

Resources:

Radiology Info—American College of Radiology
http://radiologyinfo.org
Texas Heart Institute
http://www.texasheart.org

Canadian Resources:

Canadian Association of Radiologists
http://www.car.ca

References:

Funako B. Inferior vena cava filter insertion. Semin Intervent Radiol. Dec 2006;23(4):357-360.
Inferior vena cava filter placement and removal. Radiology Info—American College of Radiology website. Available at:
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Updated February 12, 2014. Accessed September 8, 2014.
Inferior vena cava (IVC) filter placement or removal. University of Washington website. Available at: https://depts.washington.edu/uwvir/wordpress/wp-content/uploads/2012/02/Inferior-Vena-Cava-Filter.pdf. Published February 2012. Accessed September 8, 2014.
Inferior vena cava (IVC) filter replacement or removal. University of Washington Medicine website. Available at:
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Accessed September 8, 2014.
Inferior vena cava (IVC) filter retrieval. Cleveland Clinic website. Available at:
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Updated September 2012. Accessed September 8, 2014.
Inferior vena cava (IVC) filters. University of Michigan website. Available at:
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Accessed September 8, 2014.
Patel S, Patel R, et al. Inferior vena cava filters for recurrent thrombosis. Tex Heart Inst J. 2007;34(2):187-194.
Pulmonary embolism (PE). EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated August 1, 2014. Accessed September 10, 2014.
Rajasekhar A, Streiff M. Vena cava filters for management of venous thromboembolism: a clinical review. Blood Reviews. 2013;27:225-241.
Last reviewed December 2015 by Michael J. Fucci, DO

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