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IVC Filter Placement / Retrieval

Learn about IVC filter placement and retrieval.

WHAT IS AN IVC FILTER?

An IVC filter is a small, cone-shaped device that can be placed inside the inferior vena cava (IVC) vein just beneath the kidneys to prevent blood clots in the legs from migrating to the heart or lungs.

IVC filters are designed to be either permanent or retrievable at a later date, and Dr. Tahara will carefully explain which type of filter is most appropriate for your age and condition should you require IVC filter placement.

Also important to note is that there are newly emerging technologies in IVC filter design that have made it possible for some patients to conveniently receive next generation bioconvertible IVC filters (meaning that no retrieval procedure will be needed in the future).  Allegheny Vein and Vascular is committed to making these next gen devices available to patients who are good recipient candidates.

THE PROS AND CONS OF IVC FILTERS

There can be no doubt that IVC filters are beneficial and do save lives.  However, there are risks associated with any kind of medical procedure.

Some of the main benefits associated with IVC filters are:

  • IVC filters can be lifesaving in high risk PE patients
  • Nonpermanent (retrievable) filters can be used in patients with transient risk factors
  • IVC filters are critically important for patients who cannot be treated with anticoagulants

The risks associated with IVC filters are:

  • Increased risk for bleeding and infection
  • Significant clot accumulation inside the IVC filter may cause clot formation further down your inferior vena cava (IVC) vein
  • IVC filters can tilt, migrate or even fracture over time
  • IVC filters can cause vein perforation

WHEN AND FOR WHOM ARE IVC FILTERS PLACED?

The function of the inferior vena cava is to return deoxygenated blood from the lower body back to the heart. The reason for placing the filter inside the inferior vena cava vein is to prevent a blood clot from traveling to the heart and lungs. Depending on the size of the clot and where it lodges, a blood clot may cause either chronic lung or heart issues and, all too commonly, cause death. In fact, the latest data available suggests that up to 100,000 Americans die each year from blood clots experienced in PE and DVT incidents.

Specifically, an IVC filter is placed in patients diagnosed with a pulmonary embolism (PE) and/or a deep vein thrombosis (DVT) who are not able to be treated with blood thinners (anticoagulants).  IVC filters may also be placed in patients who will undergo a surgical procedure that increases the risk for DVT or PE.

HOW ARE IVC FILTERS PLACED?

Dr. Tahara will place the IVC filter in your inferior vena cava vein through an access point in you neck or groin (usually the neck). Once the vein is accessed, a catheter is inserted and contrast (x-ray dye) is injected to allow for detailed images to be taken of the inferior vena cava vein. The IVC filter can then be guided to the optimal position within the interior vena cava.

Note: IVC placement is an image-guided procedure where fluoroscopy (real-time x-rays) is most frequently used.  However, intravascular ultrasound (IVUS) may also be used in circumstances where contrast cannot be employed.

HOW ARE IVC FILTERS RETRIEVED?

If you receive a temporary IVC filter, that filter will be removed in a procedure much like how it was placed about 6 to 8 weeks after the initial placement. Contrast is once again used, this time to provide detailed images of IVC filter to ensure that the area beneath the filter is free from blood clots. Once Dr. Tahara determines that removing the filter is safe, a catheter-based snare is used to capture it. A removal sheath is used to envelop the filter to and safely remove it from the body. Much like IVC filter placement, pressure is applied to the access site to control bleeding (typically minimal) at the conclusion of treatment.

PRIOR TO YOUR PROCEDURE

IVC filter placement and retrieval is an outpatient procedure we regularly perform at Allegheny Vein and Vascular and usually takes about an hour.  The entire treatment — from preparation through placement, retrieval and recovery — may take up to 2 hours.

Dr. Tahara will provide you with detailed instructions about how to prepare for the procedure during your initial evaluation. Dr. Tahara also explores your medical history during pre-op evaluation, including inquiries about recent illnesses, existing medical conditions, and any allergies you have or medications you’re taking. He will carefully explain how you should manage your regular medications, food, and drink just prior to the procedure. As a typical example, you may be told not to eat or drink anything several hours before arrival. You may also be asked to wear loose and comfortable clothing and refrain from wearing jewelry.

WHAT TO EXPECT AFTER YOUR PROCEDURE

The Allegheny Vein and Vascular nursing staff will call you about 24 hours after your procedure to check up on you. Typically, the patient will also come in for a followup visit with Dr. Tahara about a week after the procedure is completed.  From there on out, you will be scheduled for office visits and duplex ultrasound appointments as necessary.

IMPORTANT: It is vital that patients keep their followup appointments.  The reason for this is that vascular disease is not something that just goes away.  It is a process that continues, even after any necessary procedures have been performed.  Regular monitoring of your condition will be required in order to help you realize your best possible outcome for the long term.

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