Inferior Vena Cava (IVC) Filter
An inferior vena cava filter (IVC) is used to prevent blood clots from getting to your lungs and heart. People with cancer can be at a higher risk of blood clots and an IVC filter may be placed. This article explains more about IVC filters and how they are placed.
What is the Inferior Vena Cava (IVC)?
The vena cava is the largest vein in the body. It carries blood to the heart from other areas of the body. The vena cava has two parts:
- The inferior vena cava (IVC): Carries blood from the legs, feet, and organs in the abdomen (belly) and pelvis to the heart.
- The superior vena cava (SVC): Carries blood from the head, neck, arms, and chest to the heart.
What is deep vein thrombosis (DVT)?
Blood clots that start in the legs, feet, pelvis, or abdomen (belly) are also called deep vein thrombosis (DVT). These blood clots can be dangerous if they break loose. They can then travel through the bloodstream to the lungs, blocking blood flow to the lungs. This is called a pulmonary embolism (PE), which is an emergency. These clots can also cause blockages in and near the heart.
Blood clots are most often treated with blood thinners. Some people with cancer may not be able to take blood-thinning medicines. For those people, an IVC filter may be used.
People with cancer are at a higher risk of getting a DVT for a few reasons:
- Cancer cells can activate your body’s clotting system.
- Implanted catheters such as PICC lines, Hickman catheters, and Port-a-caths increase the risk for clots.
- Some cancer medications increase the risk of blood clots.
- Long periods of not moving increase the risk of clots.
What is an IVC filter?
The IVC filter is a small metal device that is shaped like an umbrella. The filter allows blood to flow normally but traps pieces of blood clots that are traveling through the IVC before they can reach the heart or lungs. The IVC filter can be permanent, meaning it stays in your body forever, or temporary, meaning it can be taken out at a later time. Your care team will talk with you about which filter is right for you.
How do I prepare for the procedure?
Your provider will go over how to prepare for IVC filter placement, including which medications to stop taking and when.
How is the IVC filter placed?
IVC filters are often placed in the Interventional Radiology (IR) department by a doctor called an Interventional Radiologist. They may also be placed in the operating room (OR). Most times this is done as an outpatient procedure so you can go home after. Your provider will go over your specific procedure and what will happen, but in general:
- You will lie on your back.
- An IV will be placed in your hand or arm. You will receive medication to keep you calm or to help you sleep.
- You will be hooked up to monitors to track your heart rate and blood pressure.
- With the help of an X-ray or ultrasound to see inside the body, the Interventional Radiologist will insert a catheter (long, hollow, flexible tube) through a large vein, often in your neck or in your upper leg.
- Contrast dye is placed into the catheter to make sure it is in the right spot. You may feel some warmth or burning when the dye is injected, but this will quickly get better.
- The IVC filter is then released into the inferior vena cava, where it expands and attaches to the walls of the inferior vena cava.
- When the IVC filter is in the right spot, the catheter will be removed from the vein.
- Pressure is applied to where the catheter is removed to stop any bleeding. You may need to lie flat for several hours to be sure there is no bleeding.
When should I contact my healthcare provider?
After you have had your IVC filter placed and are cleared to go home, your care team will go over any changes you'll need to make in your activity level.
- Ask your provider when you can resume your normal day-to-day activity.
- Call your provider if you have:
- Bleeding, drainage, or pain at the place where the catheter went in.
- Redness or swelling where the catheter went in.
- Shortness of breath, chills, or fever of 100.4° F (38° C).
- If you have a hard time breathing, call 911 or go to the Emergency Room right away.
Barnes JA, Goodney PP. Evidence Supporting the Use of Inferior Vena Cava Filters in Patients With Cancer—Coming Into Focus. JAMA Netw Open. 2020;3(7):e2011942. doi:10.1001/jamanetworkopen.2020.11942.
Mansour, A., Ismael, Y., & Abdel-Razeq, H. Inferior vena cava filters in patients with advanced-stage cancer. Hematology/Oncology and Stem Cell Therapy. 2014; 7(3): 136-141. doi: https://doi.org/10.1016/j.hemonc.2014.09.005
Society of Interventional Radiology. (2020). Inferior Vena Cava Filter Placement and Removal. Retrieved from https://www.radiologyinfo.org/en/info/venacavafilter