Inferior Vena Cava Filter Placement

What is inferior vena cava filter placement?

Inferior vena cava (IVC) filter placement is a procedure used to put a small filter in the large abdominal vein that returns blood to the heart from the lower part of your body. This vein is called the inferior vena cava. The filter can trap blood clots and keep them from reaching your lungs. Your healthcare provider will use a soft thin tube called a catheter to put the filter into your vein.

When is it used?

IVC filter placement may be done to prevent pulmonary embolism. A pulmonary embolism is a blood clot that forms in one part of your body and travels in the bloodstream to your lungs. The blood clot can block an artery in your lungs. It can be a life-threatening problem because it stops blood from then reaching part of your lungs and other parts of your body. The lack of blood can damage your lungs and other parts of your body.

You may need this procedure if:

• You have blood clotting problems, such as deep vein thrombosis (DVT). DVT happens when a blood clot forms in a deep-lying vein, usually in the legs. Such a clot is dangerous because the clot may break loose, travel through your bloodstream, and block an artery in your lungs.
• You are at risk of having blood clots, for example, during surgery or pregnancy or after an injury.

Blood clotting problems and pulmonary embolism are usually treated or prevented with medicine called an anticoagulant, or blood thinner. The medicine makes it harder for your blood to clot. It can stop a clot from getting bigger and stop more clots from forming. However, there may be reasons you cannot take an anticoagulant. Or anticoagulant treatment may not be working well enough and you keep having more blood clots. In this case, IVC filter placement is an alternative treatment. The filter does not stop clots from forming, but it can keep clots from reaching your lungs.

How do I prepare for the procedure?

Before the procedure, your healthcare provider will want to know what medicines you are taking. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your procedure. Talk with your healthcare provider about what medicines you should take before the procedure. Your provider may prescribe medicine to prevent blood clots from forming during the procedure.

Tell your provider if you have had any kidney problems or reactions to iodine-containing foods, such as seafood, or chemicals, such as X-ray contrast dye.

Follow the instructions your healthcare provider gives you. Eat a light meal the night before the procedure. You may be asked not to eat or drink anything for 12 hours before the procedure. If you have diabetes, your provider may give you special instructions about your diabetic medicine.

Arrange for someone to drive you home after the procedure.

What happens during the procedure?

This procedure is usually done at the hospital.

You will be given medicine to help you relax, but you will be awake during the procedure. You will also be given a shot of anesthetic to numb the area where the catheter will be inserted.

Your healthcare provider will put the catheter through your skin and into a blood vessel in your groin or neck. Ultrasound or X-rays will be used to see the catheter and guide it to the right place in your vein. A special kind of liquid (called contrast or dye) may be injected through the catheter to help your provider see the catheter with X-rays. You will not feel the catheter as it passes through your blood vessels.

After the IVC filter is inserted into the inferior vena cava through the catheter, the catheter will be removed.

At the end of the procedure, your healthcare provider will remove the catheter and put pressure on the area where the catheter was inserted (the puncture site) to control any bleeding.

What happens after the procedure?

After the procedure you may stay in an observation area for at least a few hours to make sure the puncture site is not bleeding.

Avoid any strenuous activity for the rest of the day to prevent bleeding. You may have a bruise near the puncture site and be uncomfortable for a few days.

Ask your healthcare provider how to take care of yourself at home. Ask about what symptoms to watch for, and what precautions you should take. Make sure you know when you should come back for a checkup.

Some IVC filters are permanent and some are temporary. If the filter is temporary, you will have another procedure to remove it with a special catheter at a later time.

What are the benefits of this procedure?

IVC filters are a safe and effective way to prevent a life-threatening pulmonary embolism.

What are the risks of this procedure?

Complications from this procedure are uncommon. Possible risks include:

• If a dye is used you may have an allergic reaction to it. An allergic reaction may cause hives, trouble breathing, a drop in blood pressure, unconsciousness, or swelling of the skin. This reaction can be treated with medicine.
• The dye could damage the kidneys. If you have diabetes or kidney disease, you may have a higher risk for kidney damage. Your healthcare provider may want you to take medicine before and after the test to help protect your kidneys.
• You may have bleeding where the catheter was put into your blood vessel.
• A blood clot could form around the catheter or filter. A clot could block your vein.
• The catheter may damage a blood vessel, for example, the vessel in the groin or arm where the catheter was inserted.
• After a while, the filter may break or move to a different place in your vein. If this happens, you may need more surgery.
• Air or gas may collect in your lung and cause part or all of your lung to collapse.
• In rare cases, you may have an allergic reaction to the drug used in the anesthesia.

You should ask your healthcare provider how these risks might apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• The place where the catheter was put into your skin starts to bleed or swell, or it gets more painful.
• You have a fever.
• Your leg or foot is painful or unusually cool.
• You have slurred speech, balance problems, or trouble using your arm or leg.
• You start having a rash, itching, sweating, or trouble breathing.
• You have chest pain that is new or different from chest pain you have had before.

Call during office hours if:

• You have questions about the test or its result.
• You want to make another appointment.