Patient education: IVC filter placement (The Basics)

What is an IVC filter? — 

"IVC" stands for "inferior vena cava." This is the large vein that carries blood from the legs and lower half of the body back up to the heart and lungs. An IVC filter is a device that is placed in the IVC to prevent blood clots from the legs or pelvic area from traveling to the lungs.

To put in an IVC filter, the doctor places a thin, flexible tube (called a "catheter") into a vein. They push the closed IVC filter through the vein to the correct place, then open it.

IVC filters can be removed after a short time, or left in place for longer.

Why are blood clots dangerous? — 

If a blood clot forms or gets stuck inside a blood vessel, it can clog the vessel and keep blood from getting where it needs to go.

A blood clot that forms in a deep vein is called a deep vein thrombosis ("DVT"). A DVT in the legs or pelvic area (where the legs connect to the body) can travel to the lungs and block 1 or more of the blood vessels that supply blood to the lungs. When this happens, it is called a pulmonary embolism ("PE").

A PE can cause chest pain and trouble breathing. Sometimes, it can even lead to death.

Who might need an IVC filter? — 

Your doctor might suggest an IVC filter if:

●You cannot safely take medicine for blood clots.

●You form clots even while taking medicine for blood clots.

●You have a dangerous bleeding problem while taking medicine for blood clots.

●Your lungs and heart might not be able to handle another PE.

How do I prepare for an IVC filter? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Before the procedure, your doctor will do an exam. They might send you to get tests, such as:

●Lab tests

●Ultrasound or other imaging tests – These take pictures of the inside of the body.

Your doctor will also ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes prescription and "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have, especially any allergies or reactions to contrast dye

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before the procedure – You might need to "fast" before the procedure. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure.

●What help you will need when you go home – For example, you might need someone else to bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during an IVC filter placement? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure you do not feel pain and to keep you comfortable during the procedure. Types of anesthesia include:

•Local – This numbs a small part of your body so you don't feel pain. Most people only need local anesthesia for IVC filter placement.

•Regional – This blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. You might be awake. Or you might get "sedative" medicines to make you relax and feel sleepy.

•General – This makes you unconscious so you can't feel, see, or hear anything during the procedure. You might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will use a needle to help locate a vein in your groin or neck. Sometimes, they will make a small cut in the skin to locate the vein. Then, they will put a catheter in your vein. They will gently push the catheter through your vein to reach your IVC.

●While this is happening, an X-ray will take pictures of the catheter in your body. This helps your doctor know when the catheter reaches the correct place. They might also use ultrasound to help them place the catheter.

●When the catheter is in place, the doctor will inject a dye into it that shows up on an X-ray. This dye can show narrow or blocked areas in your IVC or other problems. It also lets the doctor measure your IVC to choose the correct filter size. Your body might feel warm during this part.

●The doctor will pass the closed filter through the catheter into the correct place in your IVC. Then, the doctor will open the filter. The filter will expand and hold itself to the walls of your IVC.

●The doctor will remove the catheter from your body and put pressure on the area to prevent bleeding. They will cover the "access site" (where the catheter went in) with a bandage.

●The procedure takes about 1 hour.

What happens after IVC filter placement? — 

The staff will watch you closely as your anesthesia wears off. Some people can go home after the procedure. Others stay in the hospital overnight or longer.

As you recover:

●You need to stay in bed for a short time. You might need to lie with your head elevated or leg straight, based on which blood vessel was used.

●You will get medicine to help with pain, if needed. You might need other medicines, too.

●Keep your bandage on for a few days. The doctor or nurse will tell you how long to keep it on.

What are the risks of an IVC filter? — 

Your doctor will talk to you about all the possible risks and answer your questions. Possible risks include:

●Infection

●Bleeding

●The filter causing a hole in your IVC or in another blood vessel

●The filter moving out of place

●Part of the filter breaking off

●Small blood clots passing through the filter

●Additional blood clots forming

●The IVC filter getting blocked with blood clots

What follow-up care do I need? — 

The doctor will want to see you again after the procedure to check on your progress. Go to these appointments. In the future, if you no longer need the filter, your doctor will schedule a date to have it removed.

When should I call the doctor? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if you:

●Feel out of breath, or have trouble breathing

●Have sharp or severe chest pain when breathing

●Cough up blood

Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●Your access site is bleeding, or has redness or swelling around it.

●Your access site was in the groin, and your leg:

•Becomes swollen, warm, or painful

•Hurts when you walk

•Turns pale, blue, or gray, or becomes numb

●Your access site was in the neck, and:

•Your neck becomes swollen, warm, or painful.

•You have trouble swallowing or breathing.

More on this topic

Patient education: Deep vein thrombosis (blood clot in the leg) (The Basics)
Patient education: Pulmonary embolism (blood clot in the lung) (The Basics)

Patient education: Lower extremity chronic venous disease (Beyond the Basics)
Patient education: Deep vein thrombosis (DVT) (Beyond the Basics)
Patient education: Pulmonary embolism (Beyond the Basics)