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 traveling to the lungs.

The doctor will place a thin, flexible tube (called a "catheter") into a vein. The closed IVC filter is pushed through the vein to the correct place, then opened.

IVC filters can be kept in place for a short time, or they can be permanent.

Why are blood clots dangerous? — If a blood clot forms or gets stuck inside of a blood vessel, it can clog the vessel and keep blood from getting where it needs to go.

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

A PE can cause chest pain and make it hard to breathe. 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 your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Lab tests

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

Your doctor will also ask you about your "health history." This involves asking you questions 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 any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of 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 your procedure – In some cases, you might need to "fast" before the procedure. This means not eating or drinking anything for a period of time. In other cases, 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 you are having.

●What help you will need when you go home – For example, you might need to have someone else 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 that you do not feel pain and to keep you comfortable during the procedure. Types of anesthesia include:

•Local – This type of anesthesia uses medicine to numb a small part of your body so you don't feel pain. Local anesthesia is usually all that is needed for most people.

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

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, 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 thin, flexible tube in the vein. This is called a "catheter." The doctor will gently push the catheter through the vein to reach the IVC.

●While this is happening, an X-ray will take pictures of the tube in your body. This helps your doctor know when the tube has reached the correct place.

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

●The doctor will pass the closed filter through the tube into the correct place in the IVC. Once there, the doctor will open the filter. The filter will expand and attach itself to the walls of the IVC.

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

●The procedure takes about 1 hour.

What happens after IVC filter placement? — After your procedure, the staff will watch you closely as your anesthesia wears off. Some people are allowed to go home after the procedure. Others stay in the hospital overnight or longer.

As you recover:

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

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

What are the risks of an IVC filter? — Your doctor will talk to you about all of the possible risks and answer your questions. Possible risks include:

●Infection

●Bleeding

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

●The filter moving out of place

●Small blood clots passing through the filter

●Additional blood clots forming

●The IVC filter becoming 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. Your doctor might want to schedule a date to take out the filter.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or skin tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

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.

●You have sharp or severe chest pain when you breathe.

●You are coughing 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 in color or becomes numb

More on this topic

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

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