IVC Filter Placement / Removal

What is an IVC Filter?

An IVC filter is a small metal device that is shaped like an umbrella without the covering cloth. Its shape helps it catch clots that are traveling from the lower extremities, through a large vein in your abdomen called the inferior vena cava (IVC) on their way back to the heart and lungs.

Why do I need an IVC filter?

Blood clots that develop in the veins of the leg or pelvis, a condition called deep vein thrombosis (DVT), can occasionally break apart and large pieces of the clot can travel to the lungs. An IVC filter 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 or even death.

How is the procedure done?

Whether you are getting an IVC filter placed or removed, the procedure is essentially the same.

The procedure is done at El Camino Hospital where you will be set up with an IV to allow access for moderate (also known as “twilight”) sedation. You will then be taken to the procedure room where you will have a team of two nurses, a radiology technician and your interventional radiologist. You will be connected to heart rate, blood pressure and oxygen saturation monitors during the entire procedure. IV medication will be administered to make you comfortable (moderate sedation). Then your interventional radiologist will administer numbing medication (local anesthetic) to the procedure site. Using ultrasound guidance a catheter will be inserted through a vein in your neck and a small catheter will be inserted. This catheter will be maneuvered to the IVC using x-ray (fluoroscopy) guidance. If you are getting a filter placed, the filter device will be deployed inside the IVC. If you are getting your filter removed, the filter is collapsed like an umbrella and removed. After completion, the catheter is removed and a small amount of skin glue is applied to your procedure site in your neck. The procedure takes only 15-30 minutes, but expect a 4 hour day at the hospital from start to finish.

What should I expect after the procedure?

You will recover after your procedure for about 30 minutes where your procedure site, heart rate, blood pressure, and oxygen will be monitored. Your family will be able to see you soon after the procedure in the post-operative area and you will be able to eat and drink.

What are the possible complications?

Bleeding at the puncture site: although it is normal to have bruising at the procedure site, it is extremely rare to have a severe bleeding complication after the filter placement or removal. If you develop worsening swelling in the neck or difficulty breathing you should contact your physician immediately or proceed to the nearest emergency room.
Clogging of the filter: although uncommon, one of the risks of having an inferior vena cava filter in place is clogging. That may develop if the filter catches a big piece of clot or if you develop scarring of the main vein in the abdomen. If that happens, it will usually cause severe swelling of one or both legs. If there is an increasing swelling of the lower extremities, you should contact your interventional radiologist. Often, the new blood clots can also be removed.
Migrated or irretrievable filter: in some rare cases, a filter may be irretrievable due to it dislodging, migrating to another position, or is embedded into the blood vessel side wall. This is typically asymptomatic and incidentally discovered during filter retrieval, but sometimes can be seen on imaging.

When should you call your physician?

Fever or chills > 101.5 F

Worsening of redness or worsening of pain at the puncture site
New leg swelling or neck swelling
Worsening abdominal pain.

You can reach your Interventional Radiologist at 650-404-8445 during M-F 8-5pm, or the physician can be reached through the operator after hours or on weekends by calling 408-739-6000 and asking for the Interventional Radiologist “on call.”

General Instructions following placement or removal of an IVC filter:

Sedation

If you received sedation, you should not drive, consume alcohol, operate heavy machinery or make any important decisions for the remainder of the day.

Activity

You may resume your regular activities (including driving) after 24 hours, unless you have been restricted for another reason.
No exercising, lifting heavy objects or strenuous activity for the next 24 hours.
You may shower the same day of the procedure.

Pain Management

You may use over the counter medication such as Acetaminophen (tylenol) or Ibuprofen (Advil /Motrin) for minor discomfort, unless you are restricted from taking these medications.

Diet

You can resume your normal diet you were on prior to your procedure.. Some patients may develop nausea after the sedation. Therefore light meals are recommended until you know that you can eat without problems.

General Concerns if you have an IVC Filter

Going through security at an airport is not an issue. The IVC filter should not set off the alarm in the metal detector
The IVC filter is MRI compatible, so there is no restriction for having an MRI scan.

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