What is it?
This procedure (sometimes called an IVC filter) is basically an attempt to keep a blood clot found in the legs (DVT) from traveling to the lungs and causing a potentially deadly pulmonary embolus (PE).
What are the indications for the procedure?
Most often we do this procedure when a patient has a blood clot in their legs and is unable to be treated successfully or safely with traditional blood thinning medications.
How is it done?
When we’re ready to start you’ll be brought into the cardiac catheterization lab (much like an operating room with x-ray cameras) and you’ll lie on a table while our technicians prepare the area on your body where we’ll be working. In most patients we get access to the venous system through the femoral vein in the right or left groin. In some cases we use the vein in the chest or neck area.
You’ll receive some light sedation through your IV. Our goal is to make you comfortable without putting you all the way out. If, during the procedure, you find yourself anxious just let us know and we can give you more medication. We then numb the skin with anesthetic (this is the only part that should be painful in any way) and place a sheath (much like an IV) into the artery.
Through the sheath we pass catheters of various sizes into the vena cava (the main vein draining blood from the lower half of the body). We inject iodine-based dye into the vein and film it with an x-ray camera. This allows us to see the vein in great detail and allows us to place the filter in the appropriate position. The filter is a small stainless steel device that looks somewhat like a badminton birdie.
Following the procedure we have to seal the hole by holding pressure for a few minutes and have you lie on your back for an hour or so. Once you’ve recovered for a sufficient period you’ll be dismissed with instructions on how to take care of the access site and what activity you can pursue.
How do you prepare for the procedure?
IVC filter placement is done on both hospitalized and ambulatory patients. As an outpatient having this done electively you will often first visit with the cardiologist in the office to go over the procedure and discuss the risks and alternatives. Since you will be asked to sign document of consent be sure to ask any question and raise any concern you may have. You will need to have basic blood work done and this can be drawn in the office.
Unless instructed otherwise you should be fasting on the morning of the procedure. In general we want you to take your usual morning medications with the exception of any we’ve told you not to take (please talk to our nurses or schedulers if you have any questions about this).
We do this procedure in the hospital at Midlands, Bergan, Mercy, Immanuel and Lakeside and you’ll receive specific instructions on where to show up and what time to be there.
What are the risks of the procedure?
Because this is an invasive test there are certain risks that you need to be aware of. Fortunately we encounter these extremely rarely. The risk of death, heart attack or stroke is less than 1 in 5000. Bruising at the access site occurs in many people but very few of these will have enough bleeding into the groin that we have to surgically address this. The IV contrast can rarely cause an allergic-type reaction in people with a history of iodine allergy and can be harmful to patients with poor kidney function.