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Inferior Vena Cava Filter Placement and Removal

Last updated Jan. 26, 2019

BozMo

Image showing an example of the filter that is placed in the IVC.


Background Information:

What are the other Names for the Procedure?

  • Inferior Vena Cava Filter Insertion and Removal
  • IVC Filter Placement and Removal

What is Inferior Vena Cava Filter Placement and Removal radiology procedure? (General Explanation)

  • The inferior vena cava (IVC) is a large vein in the abdomen that returns blood from the lower body, to the heart
  • In a certain condition, called deep vein thrombosis, blood clots develop in the veins of pelvis and legs
  • These blood clots may break-up and travel to the lungs, causing serious problems
  • An inferior vena cava filter is placed, to prevent these blood clots from traveling to the heart and lungs
  • An image guidance is used to place these filters
  • Depending on the type of medical condition, these filters may be placed permanently, or can be removed, when the risk is eliminated

What part of the Body does the Procedure involve?

The IVC Filter Placement procedure involves the large vein in the neck or groin region.

Why is the Inferior Vena Cava Filter Placement and Removal radiology procedure Performed?

  • Inferior vena cava filters are used, when the patients cannot be treated with blood thinning medications alone, to prevent blood clots
  • The Inferior Vena Cava Filter Placement and Removal procedure is performed to prevent blood clots from traveling to the heart and lungs, in individuals with certain conditions. These include:
    • DVT (deep vein thrombosis)
    • Immobile patients
    • Postsurgical/hospitalized patients
    • Postpartum mothers
    • Trauma victims
    • Patients with pulmonary embolus

What is the Equipment used? (Description of Equipment)

The equipment used for an Inferior Vena Cava Filter Placement and Removal could include:

  • Catheter
  • Contrast dye for better visualization
  • X-ray or ultrasound, for image guidance
  • IVC filter
  • In case of an ultrasound:
    • The equipment consists of a transducer, computer monitor, and other electronic components
    • The transducer is used to send high-frequency sound waves in the body; the computer creates the image, based on the echoes of the sound returning from the patient’s body

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Inferior Vena Cava Filter Placement and Removal procedure.

What is the Cost of performing the Inferior Vena Cava Filter Placement and Removal radiology procedure?

The cost of Inferior Vena Cava Filter Placement and Removal procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Inferior Vena Cava Filter Placement and Removal procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://my.clevelandclinic.org/heart/services/ivc-filter-retrieval.aspx

http://www.radiologyinfo.org/en/info.cfm?pg=venacavafilter

http://pulmccm.org/2013/cardiovascular-disease-review/inferior-vena-cava-filters-placement-often-misguided-unhelpful-rarely-removed-jama-int-med/

Prior to Inferior Vena Cava Filter Placement and Removal radiology procedure:

How does the Inferior Vena Cava Filter Placement and Removal radiology procedure work?

IVC Filter Insertion:

  • Using image guidance, the physician inserts the catheter through a large vein in the neck or groin area
  • Catheter is advanced to the inferior vena cava, which is located in abdomen
  • An IVC filter is then placed in the IVC, using a catheter
  • Once the filter is placed in the correct position, it is released. This allows it to expand and attach to the blood vessels walls

IVC Filter Removal:

  • A catheter is inserted into a large vein in the neck or groin region
  • The catheter is advanced to the site of the IVC filter
  • The IVC filter has a small hook, which allows the catheter to capture it and pull it out

How is the Inferior Vena Cava Filter Placement and Removal radiology procedure Performed?

  • The patient is positioned on the examination table, on their back
  • An intravenous line is inserted into the arm vein, in order to administer sedative medication
  • The catheter insertion site is shaved, sterilized, and covered in a surgical drape
  • The catheter insertion site is then numbed, using localized anesthesia
  • A small skin incision is made to insert the catheter
  • The catheter is gently inserted under image guidance (x-ray/ultrasound)
  • A contrast dye is injected into the IVC, to help guide the catheter and to ensure a correct placement of the IVC filter
  • The catheter is removed at the end of the procedure and the insertion site on skin, is covered with a dressing; no sutures are needed

Where is the Procedure Performed?

The IVC Filter Placement and Removal Procedure is performed as an outpatient procedure, at a hospital. 

Who Performs the Procedure?

An interventional radiologist performs the procedure.

How long will the Procedure take?

The duration of the Inferior Vena Cava Filter Placement and Removal radiology procedure varies. However, if the narrowing is severe, the procedure may take 2 to 3 hours to place a stent inside the vein to keep it open.

Who interprets the Result?

  • An interventional radiologist interprets the images taken, to determine the correct location of the filter. It is very important that the filter is in the right location, in order to capture the blood clots
  • After the procedure, follow-up visits may be needed

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to an Inferior Vena Cava Filter Placement and Removal procedure:

  • The physician should be informed about all the medications you are currently taking including any over-the-counter (OTC) drugs and herbal supplements
  • Do inform the medical staff about any allergies; specifically, if you are allergic to iodine contrast dye, used in the procedure
  • Do inform your healthcare provider or physician, about all the medical conditions you have (if any)
  • Women should notify the physician if they are pregnant or breastfeeding their child; as many such procedures are not performed on pregnant women
  • The patients are usually instructed not to eat or drink anything after midnight, before the procedure
  • Patients may be asked to change their medication routine, including insulin for diabetic patients, if necessary
  • It is advisable not to wear any jewelry or metal objects, as you will be asked to remove them during the procedure, for it will interfere with the X-rays
  • The patients may be required to be driven home, after the procedure

What is the Consent Process before the Procedure?

A physician will request your consent for Inferior Vena Cava Filter Placement and Removal procedure using an Informed Consent Form. 

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent. 

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the procedure:

  • The procedure is very successful in preventing blood clots from reaching the lungs and heart, especially in patients in whom conventional medical therapy, such as blood thinning medication have failed
  • No major surgical incision is necessary for this procedure
  • It is an outpatient procedure

Following are the risks of the procedure:

  • There may be an allergic reaction from the contrast dye, used in the procedure
  • If the catheter insertion if not done correctly, it may damage the blood vessel, cause an infection, or lead to bruising/bleeding at the puncture site
  • The IVC filter may penetrate through the blood vessels, or may get lodged in wrong places in some cases, such as outside the blood vessels
  • The IVC filter may break and travel to the heart and lung, causing some potentially serious damage
  • There is a chance of infection, due to skin penetration for catheter and needle insertion
  • If there are too many clots filling the IVC filter, then this may block the blood flow within the blood vessel

What are the Limitations of the Inferior Vena Cava Filter Placement and Removal radiology procedure?

The procedure only prevents the blood clots from traveling to lungs and heart; it does not prevent the formation of blood clots. 

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is an Inferior Vena Cava Filter Placement and Removal procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved?

During the Inferior Vena Cava Filter Placement and Removal radiology procedure:

What is to be expected during the Inferior Vena Cava Filter Placement and Removal radiology procedure?

The following may be expected during an Inferior Vena Cava Filter Placement and Removal procedure:

  • The patient may feel a pin-prick like sensation, when the needle and catheter are inserted
  • He/she may get a warm feeling, when the contrast material is injected

What kind of Anesthesia is given, during the Procedure?

Local anesthesia may be used to numb the area, where catheter is inserted, during the procedure.

How much Blood will you lose, during the Procedure?

Since the procedure is a minimally invasive procedure, generally the blood loss involved during the procedure is minimal, unless there are any complications. 

What are the possible Risks and Complications during the Inferior Vena Cava Filter Placement and Removal radiology procedure?

The following risks are possible during the procedure:

  • In rare cases, there may be significant damage to the blood vessel causing bleeding and formation of hematoma in the soft tissues
  • Rarely, there may be an allergic reaction from the contrast dye used in the preparations
  • The IVC filter may penetrate through the blood vessels, or may get lodged in wrong places in some cases, like outside of the blood vessels
  • The IVC filter may break and travel to the heart and lung, causing some potentially serious damage to these organs

What Post-Operative Care is needed at the Healthcare Facility after the Inferior Vena Cava Filter Placement and Removal radiology procedure?

  • Generally, no significant post-operative care is needed at the healthcare facility
  • However, a short period of observation may be occasionally recommended by your healthcare provider

After the Inferior Vena Cava Filter Placement and Removal radiology procedure:

What is to be expected after the Inferior Vena Cava Filter Placement and Removal radiology procedure?

The following may be expected after an Inferior Vena Cava Filter Placement and Removal procedure:

  • The patient will be transferred to a recovery room, after the procedure and discharged, when they are completely awake; if sedation is used in the procedure
  • The patient should be able to resume their normal activities within 24 hours if IVC filter was inserted through the large vein in the neck
  • However, they should avoid driving for a period of 24 hours and lifting heavy objects or climbing stairs for a period of 48 hours, if IVC filter was inserted through the large vein in the groin

When do you need to call your Physician?

Do inform your physician or healthcare provider, in case you develop an infection with symptoms, such as fever, chills, nausea, and vomiting. 

What Post-Operative Care is needed at Home after the Inferior Vena Cava Filter Placement and Removal radiology procedure?

No specific post-operative care is needed at home after the procedure.

How long does it normally take to fully recover, from the Procedure?

  • The patient should be able to resume their normal activities within 24 hours, if IVC filter was inserted through a large vein in the neck
  • However, they must avoid driving for the next 24 hours
  • They must also avoid lifting heavy objects or climbing stairs for the next 48 hours, if the IVC filter was inserted through a large vein in the groin

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The Inferior Vena Cava Filter Placement and Removal procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient. 

Who will you receive a Bill from, after the Inferior Vena Cava Filter Placement and Removal radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Interventional radiologist, performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Inferior Vena Cava Filter Placement and Removal procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Feb. 22, 2014
Last updated: Jan. 26, 2019