IVC Filter Replacement and Retrieval
Deep vein thrombosis (DVT) is a condition in which a blood clot develops in one of the primary veins of the pelvis, thigh, or calf, or less frequently the arms, abdomen, and chest. When a clot forms, it can extend to adjacent areas of the vein, triggering a localized inflammation that may encourage additional blood clot growth. A clot in a deep vein can also increase the potential for a dangerous complication, pulmonary embolism, in which a clot breaks free, travels through the bloodstream, and lodges in the lungs, where it can cause heart and lung collapse. Some people with DVT are at a high risk for bleeding complications or have not had success with other treatments (thrombolysis, for example). In these patients interventional radiologists may place a tiny metal wire filter (inferior vena cava or IVC filter) into the vena cava, the large abdominal vein that carries blood back to your heart and lungs, to prevent clots from traveling to these organs. In many cases the filter can be removed once the risk of pulmonary embolism has passed.
What is IVC filter placement and retrieval?
An IVC filter is a tiny metal device—resembling the frame of an umbrella—that doctors can place in the inferior vena cava to prevent blood clots from traveling to the lungs. A removable IVC filter has a small hook or knob at one end, which enables interventional radiologists to grab and close it, then pull it into the catheter and then withdraw it from the body when the risk of pulmonary embolism has passed.
How do I get ready for the procedure?
On the night before the procedure eat a light meal, then do not eat or drink anything after midnight. We will provide you with more detailed information about which medications you may take in days before and on the morning of the procedure. Plan to have someone drive you home after the procedure.
What will happen during the procedure?
After you arrive at the interventional radiology suite and change into a gown, you will lie face up on the procedure table. To relax you and block any pain we will intravenously give you a combination of medicines called “conscious sedation.” Using X-ray and/or ultrasound image guidance, we will insert a long, very thin tube called a catheter through a small incision in a vein in your neck or groin. The IVC filter is mounted on the tip of the catheter; it is closed or “collapsed” at the time of insertion. Once we have advanced the catheter to the target location in the vena cava we will open or “deploy” the filter, then withdraw the catheter. The filter is designed so that it will anchor itself to the blood vessel walls. The procedure is usually completed within one hour. When the danger of a clot traveling to the lungs has passed we can remove the IVC filter during a similar procedure.
Are there any risks?
Complications from the procedure may include bleeding at the insertion site; or very rarely stroke or pulmonary embolism.
After the procedure
After the procedure we will have you rest in the recovery area. Your doctors will monitor you closely, and will refer you back to us when it is time to remove the IVC filter.