IVC Filter Placement & Retrievals | Precision VIR Dallas Fort Worth TX

IVC Filter Placement and Retrievals

The inferior vena cava (IVC) is a large vein in the middle of the abdomen. The IVC returns blood from your lower body to your heart. IVC filters are “baskets” that are made of many wires (see picture). The filter can be inserted into the IVC through a small hole in a vein in the neck or the groin. Filter placement may be done as an outpatient procedure. This means you will not need to stay overnight in the hospital.

Blood clots that develop in the veins of the leg or pelvis, a condition called deep vein thrombosis (DVT), occasionally break up and large pieces of the clot can travel to the lungs. An IVC filter traps large clot fragments and prevents them from traveling through the vena cava vein to the heart and lungs, where they could cause severe complications or even death.

IVC Filter Placement

In an Inferior Vena Cava Filter placement procedure, a filter is placed in the inferior vena cava (IVC), the large vein in the abdomen that returns blood from the lower body to the heart.

In this procedure, a catheter, x-ray or ultrasound equipment for imaging guidance and an inferior vena cava (IVC) filter may be used. A catheter is a long, thin plastic tube, about as thick as a strand of spaghetti.

Using image guidance, a catheter is inserted through the skin into a blood vessel in the neck or groin and advanced to the inferior vena cava in the abdomen. The IVC filter is then placed through the catheter and into the vein where it will attach itself to the walls of the blood vessel.

Usually, people with these health conditions are treated with a blood-thinning medicine. This medicine is either given intravenously (directly into a vein), injected under their skin, or taken as a pill. But, blood-thinning medicines are not advised for some people. Your doctors believe that blood-thinning medicines will not be safe for you, or will not work. This is why they have recommended an IVC filter for you.

Reasons For IVC Filter Placements

Your doctor may recommend Inferior Vena Cava (IVC) filters for patients who have a history of or are at risk of developing blood clots in the legs, including patients:

  • Diagnosed with deep vein thrombosis (DVT)
  • With pulmonary embolus
  • That are trauma victims
  • That are immobile
  • Who have recently had surgery or delivered a baby
  • Who are at high risk and about to undergo a surgery where they will be immobile (i.e. spine surgery).
  • Already have blood clots in the veins in your legs or pulmonary embolus.
  • Have a health condition that makes you more likely to get blood clots in your leg veins. These include a family history of clotting, a recent surgery, having leg vein clots before, or if you need to be in bed for long periods and cannot exercise.

Usually, people with these health conditions are treated with a blood-thinning medicine. This medicine is either given intravenously (directly into a vein), injected under their skin, or taken as a pill. But, blood-thinning medicines are not advised for some people. Your doctors believe that blood-thinning medicines will not be safe for you, or will not work. This is why they have recommended an IVC filter for you.

 

IVC Filter Retrievals

There are two general types of IVC filters ─ permanent and optionally retrievable. Your doctor may choose to use a retrievable filter depending on your particular risk factors, length of time you are at risk for blood clots, and ability to take blood thinners. Placement of an IVC filter does not prevent new blood clots from forming. You may also be prescribed blood thinning medications to prevent future clots.
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Reasons for IVC Filter Removal

Filters can increase risks of new blood clot formation in the legs and abdomen, and certain filter types have been found to break apart and/or cause symptoms from the filter legs penetrating the wall of the IVC, removal is recommended when the filter is no longer needed. The IVC filter should be removed within several months after it is placed. Removal is possible for about 80% of people (80 out of 100). Before it is removed, you may need to start taking blood thinners to prevent pulmonary embolism. It is very important to take this medicine exactly as prescribed. Removing the filter is usually simple and can be done as an outpatient procedure. But, the longer the filter stays in place, the harder it can be to remove.

The most common reasons that the filter cannot be removed are:

  • It gets stuck to the wall of the IVC.
  • It becomes filled with large blood clots.
  • You are not getting the right dose of blood thinner.

Retrieval of Inferior Vena Cava Filter Process

1. Access obtained through the right internal jugular vein.
2. Retrieval sheath and endosnare catheter are introduced.
3. Endosnare is used to grab the filter hook and secured.
4. Filter is collapsed within retrieval sheath and withdrawn.

How Is The Filter Removed?

The IVC filter is removed via a similar process to the way in which it was placed. X-ray dye (contrast) will be injected around the filter to assure that the area beneath the filter is free of blood clots and that it is safe to proceed with removal. A catheter-based snare will be used to engage the hook at the end of the filter and the filter will then be enveloped by a removal sheath and removed from your body.

Precision’s Dedication to IVC Filter Retrievals

At Precision we take complete ownership of the IVC filter placement and retrieval process. We track all of our filter placement patients. When the time is appropriate for retrieval our patients receive a follow-up visit and ultrasound to make sure they are free and clear of DVT. Our team of vascular specialists will carefully evaluate your condition and help to decide whether your implanted filter should be removed. Additionally, underlying blood clotting disorders will be closely monitored.The most common reasons that the filter cannot be removed are:

    • It gets stuck to the wall of the IVC.
    • It becomes filled with large blood clots.
    • You are not getting the right dose of blood thinner.

When Should the IVC Filter be Removed?

It is recommended that the retrievable filter be removed when your doctor feels that the protection from DVT or VTE it provides is no longer necessary and it is safe for the filter to be removed. Filters can increase risks of new blood clot formation in the legs and abdomen, and certain filter types have been found to break apart and/or cause symptoms from the filter legs penetrating the wall of the IVC, removal is recommended when the filter is no longer needed.

The IVC filter should be removed within several months after it is placed. Removal is possible for about 80% of people (80 out of 100). Before the filter is removed, you may need to start taking blood thinners to prevent pulmonary embolism. It is very important to take this medicine exactly as prescribed. Removing the filter is usually simple and can be done as an outpatient procedure. But, the longer the filter stays in place, the harder it can be to remove.

The DENALI Trial

An Interim Analysis of a Prospective, Multicenter Study of the Denali Retrievable Inferior Vena Cava Filter.

Purpose

To assess safety and effectiveness of a nitinol retrievable inferior vena cava (IVC) filter in patients who require caval interruption to protect against pulmonary embolism (PE).

Materials and Methods

Two hundred patients with temporary indications for an IVC filter were enrolled in this prospective, multicenter clinical study. Patients undergoing filter implantation were to be followed for 2 years or for 30 days after filter retrieval.

Results

Clinical success of placement was achieved in 94.5% of patients (172 of 182), with a one-sided lower limit of the 95% confidence interval of 90.1%. Technical success rate of filter placement was 99.5%. Technical success rate of retrieval was 97.3%; 108 filters were retrieved in 111 attempts.

F.A.Q.

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