IVC Filter

An IVC filter (Inferior Vena Cava filter) is a small, metallic, cage-like device placed in the inferior vena cava — the large vein that carries blood from the lower body to the heart — to prevent pulmonary embolism (PE) by trapping large blood clots before they reach the lungs.

🔹 Indications for IVC Filter Placement

Primarily used when anticoagulation is contraindicated or ineffective:

1. Acute venous thromboembolism (VTE) with contraindication to anticoagulation (e.g., active bleeding)
2. Recurrent PE despite adequate anticoagulation
3. Complications from anticoagulation
4. High-risk trauma patients (temporary protection)
5. Surgical patients at high risk for DVT/PE and can't be anticoagulated

🔸 Types of IVC Filters

1. Permanent filters – Designed to stay in place indefinitely.
2. Retrievable filters – Can be removed once the risk of PE decreases and anticoagulation becomes safe.

🔹 Procedure Overview

• Typically inserted via the femoral or jugular vein under fluoroscopy.
• The filter expands and attaches to the walls of the IVC.
• Procedure is minimally invasive, often done under local anesthesia.

🔸 Complications

Most are rare, but may include:

• IVC thrombosis or occlusion
• Migration or malposition of the filter
• Fracture of filter struts
• Perforation of the IVC wall
• Recurrent DVT (especially if left in place long-term)
• Difficulty retrieving the filter if not removed in time

🔹 Retrieval Considerations

• Ideally removed within 29–54 days if no longer needed
• Requires imaging (e.g., cavagram or CT) to assess position and feasibility
• FDA recommends regular follow-up for retrievable filters to avoid long-term complications

🔸 Alternatives

• Anticoagulation (first-line for most patients with DVT/PE)
• Thrombolysis or thrombectomy in certain high-risk or massive clot scenarios