Vena Cava Filter Implantation

Vena cava filter implantation is a procedure to place a device in the inferior vena cava. The inferior vena cava is the large vein that returns blood from the lower body to the heart. The device is a filter that traps blood clots in the lower body. This prevents the clots from traveling to the lungs. 

You may need a vena cava filter if you’re at risk for a pulmonary embolism (PE) and anticoagulation medicine has failed or shouldn't be used because of medical reasons. A PE can happen when a blood clot that has formed in the leg travels to the lungs. This can block blood flow in the lungs and cause death.

During vena cava filter implantation, a thin tube called a catheter is used to place (implant) a filter in the inferior vena cava. Some vena cava filters are permanent. Others are temporary. These can be removed when no longer needed. The procedure may be done while you’re already in the hospital for other health reasons. Or it may be done as a same-day (outpatient) procedure. 

Cross section of inferior vena cava showing filter in place catching blood clot. Locator shows body outline with box to show location of filter in inferior vena cava.

Preparing for the procedure

Tell your healthcare provider if you:

  • Take any medicines. This includes over-the-counter medicines. It also includes vitamins, herbs, and other supplements. You may need to stop taking some or all of them before the procedure.

  • Are allergic to any medicines. This includes iodine and dye used during some imaging tests.

  • Have other health problems, like diabetes or kidney problems.

  • Are pregnant or could be.

  • Are breastfeeding.

Follow any directions you’re given for not eating or drinking before the procedure.

The day of the procedure

The procedure takes about 1 to 2 hours. You may need to stay or be admitted into the hospital for 1 or more days afterward. Or you may be able to go home on the same day.

Before the procedure begins

Here's what to expect:

  • An IV (intravenous) line is put into a vein in your arm or hand. This line supplies fluids and medicines.

  • You’ll be given medicine (anesthesia) to keep you free of pain during the procedure. You’ll likely receive medicine to help you relax and feel sleepy (sedation).

During the procedure

Here's what to expect:

  • Numbing medicine (local anesthesia) is injected into the area where the catheter will be placed.

  • The catheter is inserted through the puncture and into a vein that leads to the inferior vena cava.

  • X-rays or ultrasound are used during the procedure. The pictures help the healthcare provider correctly place the vena cava filter. If X-rays are used, dye (contrast fluid) is first injected through the catheter. The contrast fluid helps make the vein more visible on the X-rays. If ultrasound is used, gel is first applied to the skin. A device called a transducer is then moved over the skin. It sends pictures of the blood vessels to a video screen.

  • Once the catheter is positioned, the filter is then passed through the catheter and placed.

  • After the filter is securely attached, the catheter is removed. Pressure is applied to the insertion site to stop any bleeding. A bandage is then placed over the site.

After the procedure

You’ll be taken to a recovery room to rest. There, you’ll be given medicines to manage pain and prevent infection. You may be taken to your hospital room. Or you may be released to go home after several hours. Have an adult family member or friend ready to drive you home.

Recovering at home

Once at home, follow any directions you’ve been given.

  • Take all medicines as directed.

  • Keep the area where the catheter was inserted clean and dry. Make sure you follow all directions about taking care of the area.

  • Check for increased redness, pain, swelling, or drainage at the catheter insertion site.

  • Walk at least a few times a day. Increase your speed and distance as you feel able. This helps improve blood flow and reduce the risk of blood clots.

  • Don't lift anything heavy or do strenuous activities, as directed.

  • Don't drive until your healthcare provider says it’s OK. Don't drive if you’re taking medicines that make you drowsy or sleepy.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these symptoms:

  • Fever of 100.4° F ( 38° C) or higher, or as directed by your healthcare provider

  • Increased redness, swelling, pain, or drainage where the catheter was inserted. These symptoms may mean you have an infection.

  • Increased bleeding where the catheter was inserted

  • Pain, swelling, or redness in either leg. These symptoms may mean you have a blood clot.

  • Other changes in the area where the catheter was inserted. For example, numbness or trouble moving your leg if the catheter was inserted into your upper leg area

Call 911

Call 911 if you have any of the following. These symptoms may mean a blood clot in your lungs:

  • Chest pain

  • Trouble breathing

  • Fast heartbeat

  • Sweating

  • Coughing (may cough up blood)

  • Fainting

Follow-up

Call your healthcare provider if you have any questions or concerns. And make sure you keep all follow-up appointments with the healthcare provider who performed the procedure.

Risks and possible complications

  • Bleeding or infection at the catheter insertion site

  • Damage to the vein used for the procedure

  • Problems due to contrast fluid, like an allergic reaction or kidney damage

  • Incorrect placement of the filter

  • Filter may become clogged with clots and block blood flow, which may cause severe leg swelling

  • Filter may break

  • Filter may loosen, change location, or float to another location in the body, like the heart or lungs

  • Risks of anesthesia or other medicines used during the procedure