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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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 (DVT)Prior pulmonary embolismsBleeding problemsLarge clots in the IVC or iliac veins (located near the pelvis)Hormone contraceptives or replacementObesity
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.
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 wheezingExcess bleedingDamage to the IVC The IVC filter moves from its proper position after surgeryPulmonary embolism from broken IVC filter piecesInjury to the neck or groin due to catheter insertionInfectionHeart attackSoreness in throatNausea and vomitingBlood clots—rarely, some blood clots can be caused by the IVC filterBlood 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: SmokingDrinkingChronic disease such as diabetes or obesity
Your doctor will likely do the following: Physical examBlood testsElectrocardiogram (EKG)—a test to record the heart’s activity by measuring electrical currents through the heart muscleImaging 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.
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.
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.
After the operation, you will be taken to the recovery room for observation.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
You will usually go home the same day. If you have any problems, you may need to stay longer.
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 handsWearing gloves or masksKeeping 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 sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions
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 if any of these occur: Redness, swelling, increasing pain, excessive bleeding, or any discharge from the catheter insertion sitePain that you cannot control with the medications you have been givenNausea and vomiting Chest painSigns of infection, including fever and chillsCough, shortness of breath, or chest painYour legs become blue and cold
If you think you have an emergency, call for emergency medical services right away.
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Inferior vena cava filter placement and removal. Radiology Info—American College of Radiology website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=venacavafilter. 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: http://www.uwmedicine.org/health-library/Pages/inferior-vena-cava-ivc-filter-replacement-or-removal.aspx. Accessed September 8, 2014.
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Inferior vena cava (IVC) filters. University of Michigan website. Available at: http://surgery.med.umich.edu/vascular/patient/treatments/ivc_filters.shtml. 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: http://www.ebscohost.com/dynamed. 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 November 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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