Inferior Vena Cava (IVC) Filters
The Vascular Surgery team at the University of Michigan is dedicated to providing exceptional patient care in the U-M Cardiovascular Center (CVC), our new state-of-the-art clinical building.
Our vascular surgeons have extensive experience in placing inferior vena cava (IVC) filters to help prevent pulmonary emboli and we are continuing to investigate and research new advances for treatment in this area.
What is an IVC filter?
The inferior vena cava is the largest vein in the body. It carries de-oxygenated blood from the lower extremities to the right atrium of the heart and then to the lungs.
An inferior vena cava filter or IVC filter is a small cone-shaped device that is implanted in the inferior vena cava just below the kidneys. The filter is designed to capture an embolism, a blood clot that has broken loose from one of the deep veins in the legs on its way to the heart and lungs.
Without the IVC filter in place, there would be the potential for the embolism to cause a blockage of the pulmonary artery. The pulmonary arteries carry deoxygenated blood from the heart to the lungs. Blockage of one or both arteries is referred to as a pulmonary embolism (PE) and can cause difficulty breathing, chest pain, and death.
The IVC filter works by permitting blood flow to continue around the trapped clot. Over time, natural anticoagulants in the blood will help to break the clot down.
Who is a good candidate to receive an IVC filter?
You are a good candidate for the placement of an IVC filter if:
- You continue to develop deep vein thrombosis (DVT) or pulmonary emboli despite the monitored use of anticoagulants (e.g. Coumadin, low-molecular-weight heparin).
- You are at risk of a pulmonary embolism, but cannot tolerate anticoagulation therapy due to another condition that puts you at the risk of bleeding.
- You develop significant bleeding complications from anticoagulation
- You have large clots in the inferior vena cava or iliac veins
U-M vascular surgeons who perform IVC filter placement
For details about education, experience, and specialty in this clinical area, please visits these physician profile pages:
How do I prepare for the placement of an IVC filter?
Your doctor will give you detailed instructions as to how to prepare for the procedure. These may include a suggestion to eat a light meal the night before the procedure and to not eat or drink anything after midnight before the procedure. If you regularly take any important medicines, your physician may ask you to take them on the day of surgery with a sip of water.
Follow your doctor's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your body will heal much better if you do not smoke after the surgery.
- Plan for your care and transportation after the procedure and during recovery at home.
- Before the procedure tell your health care provider if you have had any kidney problems or reactions to iodine-containing foods or chemicals, such as seafood or kidney contrast dye.
- Before surgery, your health care provider will ask you to sign a consent form for angioplasty, bypass surgery, and angiography. Angiography is an x-ray study of the blood vessels using dye. This consent form is needed in case problems arise during the procedure and emergency surgery is needed.
- You will have imaging studies, blood tests, and an electrocardiogram (ECG) before the procedure.
- Someone at the hospital will shave and wash the area where the catheter will be inserted (neck or groin). This is to help prevent infection.
What happens during the procedure?
IVC filter placement is an endovascular procedure, meaning that the filter is inserted via a blood vessel. Typically, the femoral vein in the groin, or the internal jugular vein in the neck, is used.
You will be given a local anesthetic to numb the area where the catheter will be inserted. You will stay awake during the procedure, but will be sedated for comfort.
Your vascular surgeon will thread a thin guide wire through a needle inserted into a blood vessel in your neck or groin. A contrast dye will be injected into and x-rays will be taken as the dye moves through the bloodstream. Using these x-ray images, an IVC filter catheter will be advanced along the guidewire to the location of the placement. The IVC filter is then pushed through the catheter and deployed in the desired location. Once complete the catheter is then removed.
What happens after the procedure?
You will go back to your hospital room and rest in bed for 12 to 24 hours. You will most likely be able to go home the next day. You can usually resume normal activity within a day or two. Your doctor will let you know when you can return to work.
What are the risks?
- You may have an allergic reaction to the local anesthetic or x-ray dye.
- You may bleed a lot and need medicine or a blood transfusion.
- The vein may be damaged. For example, the vein might be perforated during the procedure. Emergency bypass surgery or repair of the perforation (hole) would then be needed.
- Although rare, the IVC filter itself may cause clots to form.
- The IVC filter may shift following surgery, which would require that it be captured and repositioned.
- Clots can still bypass the filter causing pulmonary embolism, however the risk is significantly reduced.
- There is a risk of injury to the neck or groin where the catheter was inserted.
There is risk with every treatment or procedure. Talk to your surgeon for complete information about how the risks apply to you.
How can I take care of myself following surgery?
- Do not smoke.
- Eat a healthy diet that is low in fat and cholesterol.
- Exercise according to your health care provider's recommendation.
- Keep your appointment for your scheduled post-discharge office visit.
When should I call my health care provider?
Call your health care provider right away if:
- You have chest pain.
- You have constant or worsening pain or numbness in your arm or leg.
- You have a fever.
- You have shortness of breath.
- Your leg becomes blue and cold.
- You have bleeding, excess bruising, or a lot of swelling where the catheter was inserted.
Make an appointment or contact us for more information.