IVC filter placement and removal

An IVC filter is a device that prevents a blood clot from blocking an artery in your lungs, called a pulmonary embolism. It is used for people with deep vein thrombosis (DVT) or other conditions that increase your risk for blood clots. If you have DVT, blood clots in your lower body can travel to your lungs and cause life-threatening complications. An IVC filter is an alternative treatment for people who can’t take anticoagulants (blood thinners).

An IVC filter is a small metal device, shaped like an umbrella. It’s implanted in your inferior vena cava, the large vein that returns blood back to your heart and lungs from your lower body. The filter allows blood to flow through, but blocks any clots before they can reach your lungs. Over time, your body’s natural blood thinners break down the trapped clot.

Some IVC filters are permanent; others can be removed. The type of filter implanted depends on a variety of factors such as your ability to take blood thinners and your risk for blood clots. An interventional radiologist performs minimally invasive procedures to place and remove IVC filters.

We can remove a retrievable filter once the threat of a pulmonary embolism has passed. Other reasons we may remove an IVC filter include:

• Filter increases the risk of new blood clots in your legs and abdomen
• Filter breaks and causes pain or damages your inferior vena cava
• You can take blood thinners and no longer need the filter

Standard IVC filter removal

An interventional radiologist uses a special device called a snare to remove IVC filters. They insert the snare into the jugular vein in your neck. Most removable IVC filters have a small hook at one end. Using fluoroscopy (X-ray guidance), we attach the snare to the hook and withdraw the filter.

Complex IVC filter removal

Interventional radiologists at Penn Medicine developed a new technique for IVC filters that are considered complex or too difficult to remove using the standard technique. We use long forceps instead of a snare to remove the filter. We may use this approach, known as the “jaws of life” technique, to remove fractured filters or filters that have become embedded in the wall of the vein. It’s now the preferred approach for high-risk IVC filter removal worldwide.

Before your IVC filter placement or removal procedure, we do a thorough physical exam and blood tests. Tell your doctor about all medications you take, any allergies you have, or if you’re pregnant or think you might be pregnant. Your care team will give you detailed instructions about how to prepare. You’ll likely be asked not to eat or drink anything after midnight before your procedure.

IVC filter placement and removal are usually outpatient procedures, so you go home the same day. An interventional radiologist performs the procedure in an operating room or catheterization lab. Both procedures last about an hour, though complex filter retrievals can take longer.

During IVC filter placement or removal, here’s what you can expect:

1. You receive a sedative through an IV in your arm. In some cases, you have general anesthesia.
2. A nurse applies a local anesthetic to your skin to numb the area.
3. We may give you an injection of a contrast dye, which helps us see blood vessels more clearly.
4. An interventional radiologist makes a small incision, or cut, in your groin or neck.
5. They insert a catheter (thin, flexible tube) and the filter or removal device into a blood vessel.
6. Using imaging guidance, they advance the filter or removal device to your inferior vena cava and either implant or remove the filter.
7. The interventional radiologist removes the catheter and places a bandage over the incision.

If your IVC filter was inserted through a vein in your neck, you can go back to work, school, or other activities within 24 hours. If your filter was inserted in your groin, you shouldn’t drive for 24 hours and avoid lifting heavy objects and climbing stairs for 48 hours. Your care team will provide additional instructions for recovery.

Complications from IVC filter placement or removal aren’t common, but can include:

• Allergic reaction to contrast material
• Bleeding
• Blood vessel damage
• Clogged IVC filter
• Embedded IVC filter
• Fractured, migrated, or misplaced IVC filter
• Infection

Expert care for IVC filter placement and removal at Penn Medicine

At Penn Medicine, our collaborative approach to care means you receive the coordinated expertise of interventional radiologists, vascular surgeons, and other experts as needed. When you turn to us for treatment, you’ll find:

• High success rate: Our interventional radiology program has a proven track record of innovation when it comes to IVC filter removal. For two decades, we worked to develop a minimally invasive technique for complex IVC retrievals. We maintain a 99 percent success rate using this approach.
• Advanced technology: We use the most advanced imaging technology available for IVC filter placement and removal, including rotational and CT venography. This imaging technique provides superior three-dimensional (3D) visualization of veins, making your procedure safer and more precise.
• Attentive monitoring: Our specialists understand the importance of removing an IVC filter at the right time. You’ll receive the follow-up care and imaging tests you need to ensure your filter is still working correctly and reduce the risk of complications.