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Photo by rawpixel.com from Pexels

Photo by taylor hernandez on Unsplash

Photo by rawpixel.com from Pexels

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Inferior Vena Cava (IVC) Filter Placement

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PROCEDURE DESCRIPTION

In an inferior vena cava filter placement procedure, interventional radiologists use image guidance to place a filter in the inferior vena cava (IVC), the large vein in the abdomen that returns blood from the lower half of the body to the heart.

Blood clots that develop in the veins of the leg or pelvis, a condition called deep vein thrombosis (DVT), occasionally break up and large pieces of the clot can travel to the lungs. An IVC filter is a small metal device that traps large clot fragments and prevents them from traveling through the vena cava vein to the heart and lungs, where they could cause severe complications such as pain, difficulty breathing, shortness of breath or even death.

Until recently, IVC filters were available only as permanently implanted devices. Newer filters, called optionally retrievable filters, may be left in place permanently or have the option to potentially be removed from the blood vessel later. This removal may be performed when the risk of clot travelling to the lung has passed. This should be assessed by a physician or the interventional radiologist who inserted the IVC filter sometime after placement, ideally less than six months after insertion. Removing an IVC filter eliminates any long term risks of filter fracture or recurrent DVT. However, it does not address the cause of the DVT. Your referring physician will determine if blood thinners are still necessary. Not all retrievable IVC filters should be removed if the risk of clots traveling to the lung persists and if blood thinners continue to be unusable. These filters can be left in place as permanent filters, but many filters can be removed even after being in place for several years.

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DO YOU NEED IVC FILTER

Inferior vena cava (IVC) filters are placed in patients who have a history of or are at risk of developing blood clots in the legs, including patients:

  • diagnosed with deep vein thrombosis (DVT).

  • with pulmonary embolus.

  • who are trauma victims.

  • who are immobile.

IVC filters are used when patients cannot be successfully treated by other methods, including blood thinning agents.

WHAT ARE THE BENEFITS vs RISKS

 

BENEFITS

  • No surgical incision is needed—only a small nick in the skin that does not have to be stitched.

  • The filter has a high rate of success in protecting lungs from serious pulmonary embolus (PE) in patients who have failed conventional medical therapy or cannot be given conventional medical therapy.

 

RISKS

  • Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.

  • There is a very slight risk of an allergic reaction if contrast material is injected.

  • Any procedure that involves placement of a catheter inside a blood vessel carries certain risks. These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection. However precaution is taken to mitigate these risks.

  • There is a chance that the IVC filter can lodge in the wrong place, change position or penetrate through the vein (which can rarely lead to injury of a nearby organ).

  • The IVC filter or a piece of the IVC filter may break loose and travel to the heart or lungs causing injury or death.

  • Rarely, IVC filers become so filled with clots that they block all flow in the blood vessel, causing swelling in the legs.

  • In some cases, retrievable filters become scarred to the vein and cannot be removed, in which case they are left in permanently (as they are also designed to do).

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