Inserted through a small incision and placed in the inferior vena cava in the leg, an IVC filter prevents blood clots from breaking loose and reaching the heart.

Lower extremity blood clots can typically be treated with blood thinning medication. In cases where the blood thinning medication is not a good option for the patient or the medication is not working, an inferior vena cava filter may be utilized.

An IVC filter resembles a small metal basket about an inch long. During a quick and very safe procedure, the filter is inserted into one of your main veins called the inferior vena cava. This vein brings the blood from your legs, feet and pelvis back to your heart. If there are blood clots in your legs or pelvis, they can travel up the inferior vena cava to your lungs where blood is being returned to be re-oxygenated. With an IVC filter in place, the basket will help trap the clots and prevent them from being transported to your lungs.

The placement of an IVC filter is performed by an OIA interventional radiologist who uses fluoroscopy to skillfully guide the insertion. The treatment effectively reduces the risk of pulmonary embolism in most people when complemented by drug therapies.

Usually, the consistency of blood remains liquid enough for the blood cells and other molecules to travel smoothly through the arteries and veins. Sometimes, however, clots will form in a process called coagulation. When clots or other blood-borne clumps of tissue migrate through the circulatory system, they are called emboli; a single migrating clot is called an embolism.

A pulmonary embolism is a clot that travels through the venous system and eventually lodges in the pulmonary artery which carries blood from the heart to the lungs. This can obstruct the blood supply to the lungs which is potentially fatal and should be treated as an emergency. Many pulmonary emboli result from a condition called deep vein thrombosis (DVT). DVT is the formation of a blood clot in the veins embedded deep in the muscles, usually in the lower leg and sometimes in the pelvis or groin.

IVC/Blood Clot Filter Insertion Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center if you are not currently a patient. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready. If you are already a patient, you will be brought from your hospital room one hour before the procedure to allow the nursing staff to get you ready.
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
• Please notify us if you’ve had a previous reaction to contrast dye.
• If you have any questions regarding your procedure, you may call us at 425-688-5507.

Preparation

• Do not eat or drink for four hours before your exam.
• Please take all your medications as usual, except aspirin, Warfarin or Metformin. If you are diabetic, you may take your regular insulin.
• If you are an outpatient, an IV will be started and blood drawn for lab tests. The nurse will review your medical history with you and your current medications. If possible, bring a list of all the medications you take and when you take them.
• The nurse will also ask you about allergies. If you are allergic to radiologic/contrast dye please let them know.
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
• The nurse or tech will clean and shave, as necessary, an area around the catheter’s point of entry.
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.

What to Expect During the Procedure

• The procedure normally takes approximately 1 hour.
• You will meet with the OIA interventional radiologist performing your procedure who will go over the consent form and answer any questions you might still have. Throughout the procedure, you will be kept informed about what is happening to you.
• You will receive sedation medication during the procedure to help you relax. You may also receive oxygen via a small face mask, if needed.
• In the procedure room you will be placed on your back on a special x-ray table. Your neck or groin will be cleaned with antiseptic fluid and you will be covered with a sterile drape.
• The doctor will give you an injection of local anesthetic to numb the skin in your neck by your collarbone or in your groin. You will feel some stinging initially, before the area becomes numb.
• During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood. Please let the nurse know if you feel any discomfort as the procedure should not cause you any pain.
  
• The OIA interventional radiologist will insert a catheter (a fine plastic tube) into the vein in your neck or groin.
  
• The doctor will inject dye to highlight your veins then take x-ray pictures to help guide the catheter into the right position. You might feel warmth, tingling or flushing when you are given the contrast dye. This usually lasts about 10 seconds.
  
• Once the catheter is in the right position, the filter will be passed through the catheter and placed in your vein. The interventional radiologist will then remove the plastic insertion tube and press on the needle site for about five minutes to make sure it stops bleeding. A dressing will be placed over the site.
  
• Once the procedure is over you will be transferred back to your room.

What to Expect After the Procedure

• You will need to rest in bed for two hours. The nurse will take your blood pressure and pulse regularly. If you feel unwell or are in any discomfort at any time, please tell your nurse.
  
• You may be able to go home the same day as your procedure. This will be determined by your referring physician or the doctor on the ward based on your physical condition.
  
• You must avoid driving on the day of your discharge, so make plans to have someone take you home.
  
• You must avoid sport, excessive activity or lifting anything greater than 5kg (11 lb) for the next 48 to 72 hours.
  
• Avoid baths for 3 to 4 days. Until the skin site is healed, you may only shower.
  
• If you experience any discomfort, take regular pain relieving medications such as Tylenol or Advil.
  
• You can remove the dressing after 24 hours and replace it with a sterile dressing daily until it heals.
  
• Drink a lot of fluids to help wash the contrast out of your system. You will need to continue to drink fluids for the first 24 hours after your procedure, unless your physician has limited your fluid intake.
  
• You will be given written instructions and a phone number to call if you have any questions or concerns.
  
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
  
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician for instructions.
• If you an insulin-dependent diabetic, restart your regular dosing when you return to your room. Check your sugar regularly and if you have a concern, contact your diabetic doctor.
  
• You may resume taking all of your normal medications once the procedure is complete.
  
• It is common to get a small bruise around the wound site.