Inferior Vena Cava Filter Insertion or Removal Patient Education

Pre-Procedure Patient Information

What is an Inferior Vena Cava Filter Insertion or Removal?

Insertion of an Inferior Vena Cava (IVC) Filter is a procedure in which a filter is placed into the large vein in your abdomen that carries blood from the lower part of your body to your heart (inferior vena cava). This filter helps to prevent blood clots in the legs or pelvis from traveling to your lungs, which can be very dangerous. When no longer needed, this filter can be removed during a separate procedure.

The filter is a small, metal device that is shaped like the spokes of an umbrella. The filter is inserted through a pathway that is created in the neck or groin. It is removed from accessing a vein in the neck. Filters are inserted when blood thinners (anticoagulants) cannot be used to prevent blood clots from forming. You may need filters rather than anticoagulants because you have:

  • Severe platelet problems or shortages
  • Recent or current major bleeding that cannot be treated
  • Bleeding associated with anticoagulants
  • Recurrence of blood clots while taking anticoagulants
  • A need for surgery in the near future
  • Bleeding in your head
  • Multiple broken bones

What conditions should I make sure my doctor is aware of?

Before your exam, you should notify the doctor or nurse of:

  • Any drug/food allergies
  • Allergies to IV contrast
  • Any blood thinning medications (anticoagulants) that you are taking
  • Any medical conditions you have
  • If you have an active infection
  • Whether you are pregnant or may be pregnant
  • Any problems you or your family members have had with anesthetic medications

What are the risks?

Generally, this is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • The filter blocking the inferior vena cava, this can cause leg swelling
  • The filter eventually failing and not working properly
  • The filter moving and traveling to the heart or lungs
  • Damage to the vein (rare)
  • Bleeding
  • Allergic reactions to medicines or dyes
  • Damage to other structures or organs
  • Infection
  • A pool of blood (hematoma) around the site where a flexible tube is put into a large vein

About the Procedure

Before the procedure:

  • Your health care provider may want you to have blood tests. These tests can help tell how well your kidneys and liver are working. They can also show how well your blood clots.
  • Do not eat or drink within eight hours of your appointment.
  • If you have diabetes and use insulin, you may need to adjust the dosage of insulin the day of the procedure. Your primary care doctor can help you with this adjustment.
  • If you are on blood thinning medications, you may need to stop them prior to the procedure. Check with your primary care doctor about when it is safe to stop blood-thinning medicine.
  • Do not discontinue any medication without first consulting with your primary care or referring physician.
  • Do not take new dietary supplements or medicines during the week before your procedure unless your health care provider approves them.
  • Plan to have someone take you home and stay with you for the first 24 hours after you leave the hospital. You should not drive or operate heavy machinery for at least 24 hours after the procedure.

The day of the procedure:

  • Make sure you shower on the day of your procedure, washing the anticipated access site with soap and water.
  • If you are told to take a medication or to continue taking a medication on the day of the procedure, take the medication with a small sip of water.
  • Please arrive and register at admissions in the lobby of the hospital at your scheduled time.
  • You will be escorted to the prep area, where you will be connected to a blood pressure machine that will take your blood pressure and your heart rate. You will also have electrocardiogram (ECG) leads placed on your chest to allow us to monitor your heart during the procedure.
  • A nurse will insert an IV into your arm. During the procedure, this IV may be used to give you medications. These medications may include medicine to help you relax and reduce pain. The area where the catheter will be inserted will be shaved. This is usually in your groin or in your neck. The nurse will also review your medical history and medications, listen to your heart and lungs and make sure you have followed all your pre-procedure instructions.
  • Your physician will obtain your consent for the procedure. The physician will explain the procedure including possible complications and side effects. They will also answer any questions you may have.

During the procedure:

You will be awake during the procedure. You will be positioned on your back for the procedure. Let the staff know if the position is not comfortable. The access site for the catheter will be cleansed with a special antiseptic solution. The procedure is done through a large vein in your neck or groin. Sterile drapes will be placed. The doctor will inject a small amount of local anesthetic through a very small needle in the skin where the catheter will be inserted. It feels like a pinch and then a slight burning as the local anesthetic starts numbing the skin.

A needle will be used to access the vein. Imaging (US) can be used to guide the needle into the vein. A small amount of dye may be injected through the needle. An X-ray can then be taken to make sure that the needle is in the correct place. Using a wire, the needle will be removed and a catheter, which is thin and flexible, will be placed.

The catheter is guided by using a type of X-ray (fluoroscopy) into the inferior vena cava. Dye is then injected into the catheter and X-rays are taken. You may notice a hot, flushed feeling as it moves throughout your body. You may also notice a metallic taste in your mouth. Both of these sensations will go away after the test is complete. The IVC filter will be inserted into the vein through the catheter until it reaches the correct location in the inferior vena cava. If the filter is being removed, a small hook at the top of the filter will be used to fold the filter into the catheter. The catheter will then be removed.

Hand pressure may be held on the access site for a period of time. Your skin will be cleansed, and a bandage will be applied.

After the procedure:

  • You will stay in the recovery area for observation for 30 minutes – 4 hours.
  • If your groin was accessed, you will have to lie flat in bed during this time. You will not be able to bend your leg.
  • The insertion site will be checked frequently.
  • You will be asked about your pain.
  • The nurses will review your discharge instructions with you.
  • You will then be discharged home. Someone must drive you home and stay will you for 24 hours.

Can I resume normal activities?

  • Do not drive or operate heavy machinery for 24 hours after the procedure.
  • Resume your normal diet.
  • Drink plenty of fluids for the first several days after the venogram. This helps flush the contrast out of your body.
  • Return to your normal activities when your health care provider says that it is safe.
  • Avoid strenuous exercise or activities that take a lot of effort for 48 hours after the procedure or as told by your health care provider.

What do I do for follow up Visits?

Please make a follow up appointment with your ordering physician for follow up care.

Contact Information:

Contact your ordering physician for any questions or concerns to include:

  • Insertion site problems to include:
    • Redness, swelling or pain
    • Fluid or small amount of blood
    • Puss or a bad smell
  • You have a fever that does not get better with medicine
  • You feel like you may vomit or you vomit
  • Your skin becomes itchy or you develop a rash or hives

Get help right away if:

  • You have very bad bleeding from the insertion site
  • You have chest pain
  • You are short of breath or have trouble breathing
  • Your have severe pain in your abdomen
  • You feel dizzy or you faint

These symptoms may be an emergency. Get help right away. Call 911.

  • Do not wait to see if the symptoms will go away.
  • Do not drive yourself to the hospital.