A blood clot in a vein (deep vein thrombosis, or DVT) can be a serious medical emergency if it breaks free and lodges in the lungs. This is called a pulmonary embolism. The best treatments for DVTs are anti-coagulant medications (Heparin) or sometimes clot-busting medicine (thrombolytic therapy). However, when you can’t take these medications, or they don’t work, your doctor may recommend inserting a filter in your vein to prevent a pulmonary embolism. A filter doesn’t prevent a clot from forming or dissolve an existing clot. It just traps the clot so it can’t reach the lungs. These filters have a special hook at the top to allow them to be removed when you no longer need them (but typically only within the first few months to about a year after placement).
We place the filter in a vein located below your kidneys called the inferior vena cava. The inferior vena cava is a large vein that runs through your abdomen. It returns blood from the lower body back to the heart.
What happens during an Inferior Vena Cava Filter insertion procedure?
You will have already discussed the treatment options with the physician doing the procedure.
Prior to your procedure, we’ll take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure. We may give you medicines to protect your kidneys, antibiotics to help prevent infection, and anti-nausea medications.
When it’s time to begin, we’ll take you to a special room that is similar to an operating room. We sometimes use conscious sedation, or mild anesthesia. In this case, you’ll remain slightly awake throughout the procedure. However, this procedure is so minor that often sedation is not required.
During the procedure, you’ll lie on your back on a table and we’ll clean the area where the catheter (a thin, hollow tube) will enter your body using a special solution to minimize infection. We’ll place sterile drapes over your body and an interventionalist will apply a local anesthetic so you don’t feel any pain.
Your interventionalist will make a small incision in your lower neck next to your collarbone, or in your groin, to insert the catheter until it reaches the inferior vena cava using x-ray and a contrast dye to guide the catheter (fluoroscopy). Once in place, your interventionalist will insert the vena cava filter. At the end of the procedure, your interventionalist will withdraw the catheter and apply pressure to the blood vessel to stop the blood from leaking out. Finally, we’ll put a bandage over the incision.
You should plan to have someone drive you home following this procedure if this is done as an outpatient procedure.
After your procedure, your interventionalist will review the results of your inferior vena cava with you and your physician so he or she can discuss the next steps with you. We will ask you to return for an office visit so we can see how well you have done after your procedure, and to see if the filter can be removed if you no longer need it.