What is Inferior Vena Cava Filter Insertion

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.

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. 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.

Tell a health care provider about:

• Any allergies you have, including iodine.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any blood disorders you have.
• Any problems you or family members have had with anesthetic medicines.
• Any medical conditions you have.
• Any surgeries you have had.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• 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. This is 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 (catheter insertion site).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• Ask your health care provider how your surgical site will be marked or identified.
• You may have blood tests. These tests can help to tell how well your kidneys and liver are working. They can also show how fast your blood is clotting.
• You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
• The procedure is done through a large vein in your neck or groin. A small cut (incision) will be made in this area.
• A flexible tube (catheter) will be put into a large vein where the incision was made.
• Contrast dye may be injected into the inferior vena cava to help guide the catheter.
• X-rays may be used to make sure that the catheter is in the correct position.
• The IVC filter will be inserted into the vein through the catheter until it reaches the correct location in the inferior vena cava.
• The catheter will be removed.
• Pressure will be applied to the insertion site to stop bleeding.
• A bandage (dressing) may be applied over the catheter insertion site.
• Your IV tube will be taken out.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Your insertion site will be monitored for the first few hours for any signs of bleeding.
• Do not drive for 24 hours if you were given a sedative.

Summary

• The inferior vena cava filter helps to prevent blood clots in the legs or pelvis from traveling to your lungs.
• The IVC filter is inserted when anticoagulants cannot be used to prevent blood clots.
• Plan to have someone take you home from the hospital or clinic, and plan to have someone with you for 24 hours if you will be going home right after the procedure.

Care After Inferior Vena Cava Filter Insertion,

Here is the information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have:

• Mild pain in the area where the filter was inserted.
• Mild bruising in the area where the filter was inserted.

Follow these instructions at home:

Insertion site care

• Follow instructions from your health care provider about how to take care of the site where a catheter was inserted at your neck or groin (insertion site). Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
• Check your insertion site every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Keep the insertion site clean and dry.
• Do not shower, bathe, use a hot tub, or let the dressing get wet until your health care provider approves.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Avoid heavy lifting or hard activities for 48 hours after the procedure or as told by your health care provider.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
• Do not drive or use heavy machinery while taking prescription pain medicine.
• Do not go back to school or work until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your insertion site.
• You have more fluid or blood coming from your insertion site.
• Your insertion site feels warm to the touch.
• You have pus or a bad smell coming from your insertion site.
• You have a fever.
• You are dizzy.
• You have nausea and vomiting.
• You develop a rash.

Get help right away if:

• You develop chest pain, a cough, or difficulty breathing.
• You develop shortness of breath, feel faint, or pass out.
• You cough up blood.
• You have severe pain in your abdomen.
• You develop swelling and discoloration or pain in your legs.
• Your legs become pale and cold or blue.
• You develop weakness, difficulty moving your arms or legs, or balance problems.
• You develop problems with speech or vision.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services. Do not drive yourself to the hospital.

Summary

• After your insertion procedure, it is common to have mild pain and bruising.
• Do not shower, bathe, use a hot tub, or let the dressing get wet until your health care provider approves.
• Every day, check for signs of infection where a catheter was inserted at your neck or groin (insertion site).