Inferior Vena Cava Filter Insertion

Insertion of an inferior vena cava (IVC) filter is usually a safe procedure. It is a procedure using a filter designed to help prevent blood clots in the legs or pelvis from traveling to the lungs. A large blood clot in the lungs can cause death. The risks involved are usually small and easily managed. This device is only used when blood thinners (anticoagulants) cannot be used. Some of these reasons may be:

  • Severe platelet problems or shortage.

  • Recent or current major bleeding which cannot be treated.

  • Bleeding associated with anticoagulants.

  • Recurrence of blood clot while on anticoagulants.

  • The need for surgery in the near future.

  • Bleeding in the head.

The filter is a small, metal device about an inch long. It is shaped like the spokes of an umbrella. The filter is placed in the inferior vena cava. The inferior vena cava is the large vein which returns blood from the lower body to the heart.

Blood clots are sometimes treated with blood thinning drugs called anti-coagulants. Filters are used when blood thinners may not be enough. Your caregivers will discuss these issues with you. Together you can determine the best course of treatment to take.

EXPECTATIONS OF A FILTER

  • An IVC filter will reduce the risk, not eliminate it and cannot prevent small PE's.

  • It does not stop deep vein clots from growing, recurring, or developing the postphlebitic syndrome.

RISKS AND COMPLICATIONS

  • Vena cava filter insertion is a very safe procedure. Occasionally a small bruise forms around the needle insertion. A larger accumulation of blood called a hematoma may form. This is usually of no concern.

  • Continued bleeding or infections are uncommon.

  • Rarely damage is done to the vein by the catheter. This may require surgery or repair. There is a possibility that the filter can cause blockage of the vena cava. This can cause some swelling of the legs. There is a possibility that the filter will eventually fail and not work properly. Despite some problems, the procedure is usually safe and carried out without them

PROCEDURE

  • The procedure usually takes about one half to one hour but this can vary.

  • A specialist in reading x-rays (radiologist) usually performs this procedure.

  • It is usually performed in a special room in the x-ray department. It is often done in a hospital or same-day surgical center. You will be asked to put on a hospital gown.

  • Let your caregivers know of all allergies. This is very important if you have reacted to a dye given through the vein (intravenous) used for x-rays.

  • Do not eat or drink for four hours before the procedure or as instructed by your caregiver.

  • Sedatives are sometimes given to relieve anxiety.

  • The procedure is often done through the femoral vein (big vein in the groin). The skin around this area is usually shaved.

  • You will lie on the X-ray table, generally flat on your back. You need to have a needle put into a vein in your arm, so that the radiologist can give you medications (sedatives or painkillers).

  • An oxygen monitoring device may be attached to your finger. Oxygen may be given.

  • Everything is kept as sterile as possible during the procedure. The skin near the point of needle insertion will be cleaned with antiseptic and the area draped with sterile towels.

  • The skin and deeper tissues over the vein will be made numb with a local anesthetic. This is a medication like Novocaine. You are awake during the procedure and can let your caregivers know if you have discomfort.

  • A needle is then put into the vein. A guide wire is placed through the needle and into the vein. This is used to help insert a catheter into your vein. The radiologist uses the X-ray equipment to make sure that the catheter and the wire are in the correct position. The wire is then withdrawn. The filter can then be released from the catheter and left in place in the vena cava.

  • The catheter is then removed. Pressure will be kept on the needle insertion point for several minutes or until it is unlikely to bleed.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop swelling and discoloration or pain in the legs.

  • Your legs become pale and cold or blue.

  • You develop shortness of breath, feel faint or pass out.

  • You develop chest pain, cough, difficulty breathing or cough up blood.

  • You develop a rash or feel you are having problems which may be a side effect of medications given.

  • You develop weakness, difficulty moving your arms or legs or balance problems.

  • You develop problems with speech or vision.