What is Venous Thromboembolism (VTE)?
Venous thromboembolism (VTE) is a condition in which blood clots form in the deep veins of the legs, pelvis or arms and travel to the heart and lungs. Blood clots which form and reside within the deep veins of the upper and lower extremities and pelvis are termed Deep Venous Thromboses or DVTs. While DVTs are not, in themselves, life-threatening, the condition can become deadly if the blood clot travels to the lungs and becomes a pulmonary embolism or PE, interrupting normal blood flow to the lungs.
How are DVTs and PE treated?
The main goal of treatment is to prevent future blood clots and to prevent existing clots from enlarging. The first step in this treatment is the use of anticoagulation medications (blood thinners), if you are able to take them. Some patients with recent surgery, for example, may not be candidates for this type of treatment.
Alternative treatment may include the placement of an inferior vena cava (IVC) filter if the patient is not able to tolerate the use of blood thinning medications. Additionally, an IVC filter may be prescribed for patients who develop recurrent blood clots or pulmonary emboli despite receiving adequate anti-coagulation therapy.
Patients for whom IVC filters may be prescribed:
- Recurrent VTE, despite treatment with blood-thinning medications
- Cannot take or tolerate blood-thinning medications due to bleeding, recent surgery or trauma or other adverse reaction to the blood thinners.
What is an IVC filter?
An IVC filter is a small metal device designed to prevent blood clots from traveling to the lungs. The filter is placed in the inferior vena cava (the large vein that takes blood back to the heart) typically just below the kidneys using a catheter type deployment device.
The procedure is performed by an interventional radiologist, interventional cardiologist or vascular surgeon. You will be awake during the procedure, but medication may be administered to help you relax. A local anesthetic is used to numb the insertion site. You will be monitored throughout the procedure.
A catheter is inserted through a small incision in your groin or neck into a large vein. The physician uses the catheter to guide the filter into place in the inferior vena cava under xray guidance. The vena cava is imaged and sized prior to filter deployment. The catheter is removed and a small bandage is placed over the insertion site.
If your procedure was performed using your groin, your activity will be briefly limited.
There are two general types of IVC filters ─ permanent and optionally retrievable. Your doctor may choose to use an optionally 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.
When should the IVC filter 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.
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.
IVC Filter Retrieval Clinic
Cleveland Clinic’s IVC Filter Clinic is dedicated to the care of patients who have potentially retrievable IVC filters. Our team of vascular medicine and interventional radiology specialists will carefully evaluate your condition and help to decide whether an implanted filter should be removed. Additionally, underlying blood clotting disorders will be closely monitored. Regular follow-up in IVC Filter Clinic allows our experienced team of physicians to remove your filter as soon as it is safe to do so.
To make an appointment, call Vascular Medicine at 216.444.4420.
Ask for Dr. Bartholomew in the Filter Retrieval Clinic.
Your appointment will include a consultation with Dr. Bartholomew and the physicians who will perform the IVC filter retrieval procedure.