Inferior Vena Cava (IVC) Filter

The standard of care for the treatment of DVT is warfarin, but if you cannot take blood thinners because of bleeding problems, recent surgery, or head trauma, or if you have a new or worsening clot while on blood thinners, your physician may advise placement of an IVC filter.

The right and left iliac veins take blood from the legs back up to the heart. These veins join at about the level of the navel to form the vena cava. An inferior vena cava filter, or IVC filter, acts as a trap or sieve to capture a blood clot that wants to travel from the legs to the heart.

Placement of the IVC filter is a minimally invasive procedure performed through a needle-stick incision. The vein at the base of your neck or in your groin is accessed with a needle, and then a catheter is guided over a wire into the vena cava. Folded inside the catheter is the IVC filter, which looks like the wire frame of a tiny umbrella. There is a small hook at the end of the filter to facilitate its removal if needed. Guided by real-time X-ray imaging, the surgeon slowly threads the catheter up to the vena cava where the filter is positioned and deployed. The catheter is then removed from the body. This procedure takes 30-60 minutes.

As with any implant, it is important that you carry a card with you that identifies the type of filter you have, its location, and when it was put in. You can’t feel the IVC filter in your abdomen and it will not set off airport scanners. Almost all IVC filters are are safe for MRI.

Most IVC filters can be removed if no longer needed. For example if a filter is placed just prior to a DVT thrombolysis procedure, it can be taken out after the clot is removed. Removing an IVC filter involves introducing a needle into a vein at the base of the neck and threading a wire and catheter down to the vena cava. A tiny lasso called a snare is advanced through the catheter and into the vena cava where it is used to grasp the small hook at top of the DVT filter. The filter is then collapsed into the sheath and removed from the body. This can be done as an outpatient procedure under a light sedative. The procedure can take 10 to 30 minutes.

Nationwide, surgeons only retrieve 50 to 75 percent of all temporary filters. After a filter has been in place three months, our chances of removing it decrease significantly. The filter may be filled with a clot, positioned so that the top hook is out of reach, or too embedded in the surrounding tissues to be removed safely.

Leaving a filter in and not being on blood thinners is associated with a small risk of development of clot in the filter which can lead to bilateral leg swelling.