Vena Cava Filters

What is a vena cava filter?

A vena cava filter is a small metal device that stops blood clots from traveling to your lungs (pulmonary embolism). Healthcare providers use two types of vena cava filter:

• Inferior vena cava (IVC) filter: An IVC filter stops blood clots from your lower body.
• Superior vena cava (SVC) filter: An SVC filter stops blood clots from your upper body.

Healthcare providers use IVC filters much more often than SVC filters.

How does an IVC filter work?

Your surgeon inserts the IVC filter into your inferior vena cava, a large vein in your abdomen. The inferior vena cava moves blood from your lower body to your heart. Your heart pumps this blood to your lungs to get oxygen. Blood flows through the IVC filter, but it traps any blood clots before they reach your lungs.

Who needs to have an IVC filter?

You may need an IVC filter if you have blood clots in your veins (venous thromboembolism or VTE) and:

• Can’t take blood-thinning medications (anticoagulants). This may be due to health issues, such as excessive bleeding, or a negative reaction.
• Have many episodes of VTE, even while taking blood-thinning medications.
• Have or have had a blood clot in a vein deep in your body — deep vein thrombosis (DVT).
• Have or have had a blood clot in your lung (pulmonary embolism) and are at high risk of recurrence.

Providers may recommend an IVC filter when you’re at higher risk of VTE due to:

• Blood clotting disorders.
• Pregnancy.
• Restricted movement (immobilization), due to trauma or surgery.

What are the types of IVC filters?

Providers use two types of IVC filters:

• Permanent: You keep this type of filter long term. People who can’t take blood-thinning medications for health reasons usually get a permanent filter.
• Optional or retrievable filters: You keep this type of filter temporarily. People with a temporary risk of blood clots or who can take blood-thinning medications at some point may get an optional filter.

How common are IVC filters?

Surgeons in the U.S. inserted more than 250,000 vena cava filters in 2012. Also in 2012, surgeons placed 25 times more filters in U.S. patients than in the five largest European countries combined.

What happens before IVC filter placement?

Before an IVC filter placement, your provider will ask you about your health history. You’ll also need to bring in a complete medication list. You may need to stop taking some of your medications a few days before your surgery, including:

• Anticoagulants.
• Aspirin.
• Nonsteroidal anti-inflammatory drugs (NSAIDs).

Your surgeon will give you specific instructions, including how long before your surgery to stop eating and drinking. They will usually ask you to stop eating about eight hours before surgery and to stop drinking about two hours before surgery.

To check your health before your procedure, you also may need:

• Blood tests.
• Echocardiogram (echo).
• Electrocardiogram (EKG).

What happens during IVC filter placement?

Vena cava filter placement usually takes about one hour. During IVC filter placement:

1. Your surgical team inserts an IV into a vein in your hand or arm. You get a sedative to relax you.
2. Your surgical team shaves hair (if needed) and cleans your skin with an antiseptic solution. They use a local anesthetic to numb the area where they’ll insert a long, thin tube (catheter).
3. Your surgeon makes a small incision in your neck or groin. They place the catheter through a vein that leads to your inferior vena cava.
4. Your surgeon uses pulses of an X-ray (fluoroscopy) to guide the catheter to your IVC. They may send X-ray dye (contrast material) through the catheter to more clearly see your IVC.
5. Your surgeon places the IVC filter in your IVC. The filter expands and attaches to your IVC’s walls.
6. Once your surgical team finishes your surgery, they remove the catheter and IV. They close and bandage the incision on your neck or groin.

What happens after IVC filter placement?

After vena cava filter placement, you’ll need to recover for a few hours at the hospital. Your surgical team will monitor your heart rate and breathing. If you have pain, your healthcare providers will offer pain medication. You also may have nausea or vomiting, which shouldn’t last long.

You can usually go home the same day as your surgery. You’ll need a friend or family member to drive you home.

What are the advantages of IVC filters?

Surgeons can insert an IVC filter through a small incision. This means it’s minimally invasive. You don’t need major surgery to have IVC filter placement.

What are the risks or complications of IVC filters?

Providers consider vena cava filter placement generally safe. There’s a small risk that you may experience:

• An allergic reaction to the contrast material.
• Bleeding or infection at the catheter insertion site.
• Damage to your blood vessels.
• Filter fracture, where the filter breaks into pieces.
• Filter that moves to your heart or lungs.
• A hole in the IVC created by the filter.
• IVC thrombosis.
• Kidney failure.
• Pulmonary embolism.

What is the recovery time after IVC filter insertion?

A vena cava filter will start working immediately. After IVC filter insertion, you may have bruising and discomfort at the catheter insertion site. Over-the-counter pain medications can help with pain relief.

Your healthcare provider will monitor your vena cava filter on a regular basis. They may suggest regular imaging tests to ensure the filter stays in the proper place.

When can I go back to work/school/drive/eat?

If your surgeon inserted the IVC filter through your neck, you can usually return to your day-to-day activities within 24 hours. If your surgeon inserted it through your groin, avoid the following activities for at least 48 hours:

• Climbing stairs.
• Driving.
• Picking up heavy objects.

Your healthcare provider will offer specific guidance for your recovery.

How long can an IVC filter stay in?

You’ll keep a permanent vena cava filter indefinitely. But your surgeon removes an optional or retrievable vena cava filter when you:

• Are able to start taking blood thinners.
• Have a lower blood clot risk.

Removing a retrievable IVC filter as soon as you no longer need it reduces your risk of complications such as:

• Filter fracture.
• Injury to your IVC.

Your surgeon will remove the retrievable IVC filter through a vein in your neck. The removal process usually takes about one hour.

When should I see my healthcare provider?

Talk to your healthcare provider if you have any of these symptoms after your IVC filter surgery:

• Chest pain.
• Continued bleeding or leaking fluid at the catheter insertion site.
• Fever.
• Nausea or headache that continues to get worse.
• Tingling or numbness in your arms or legs.
• Warmth or redness at the catheter insertion site.
• Worsening pain or swelling (edema) at the catheter insertion site.

A note from Cleveland Clinic

A vena cava filter is a metal device used to prevent blood clots in your lungs (pulmonary embolism). Your surgeon guides the filter to your inferior vena cava (IVC), a large vein that transports blood from your lower body to your heart. You may get an IVC filter if you have blood clots in your veins and can’t take blood-thinning medications. The procedure usually takes about an hour. Many people return to their regular activities in one or two days. IVC filters may be permanent or temporary (retrievable). Your surgeon will need to remove a retrievable vena cava filter as soon as you don’t need it to reduce complications.