Vena cava filter insertion
Introduction
A vena cava filter is a small metal basket, about an inch long that is inserted into one of your main veins, called the vena cava. This vein brings the blood from your legs back to your heart. If there are blood clots in your legs or pelvis, they travel up this vein to your lungs. The filter will trap the clots into the “basket” and helps prevent them going to your lungs.
Often, these blood clots are treated with blood thinning medication. Your doctor has decided that you need a filter because the blood thinning medication is not a suitable or best option for you, or the blood thinning medication is not working and you still have problems with blood clots.
Risks and benefits
The insertion of the vena cava filter is a very safe and quick procedure. It will help prevent blood clots going up your leg and into your lung, which can cause permanent damage to your lung. This is usually also done with the help of blood thinning medications.
It is common to get a small bruise around the wound site. Very occasionally the bruise might be large which carries a risk of getting infected and would require treatment with antibiotics. Very rarely, some damage can be caused to the vein which may need treating by surgery.
There is a possibility that the filter may move or that it could cause some blockage of the vena cava which may cause swelling in your legs. As with any mechanical device, there is also the possibility that the filter will eventually fail to work properly. We will discuss all the risks and benefits in detail with you before your procedure.
Day of your procedure
You may eat a light meal before your procedure. Please take all your medications as usual (except aspirin, warfarin or metformin) and, if you are diabetic, you may take your regular insulin.
If you are not already in hospital, you will be admitted to hospital. On the ward your nurse and doctor will ask you several questions about your health and current medication and they will check your blood pressure and pulse. They will do a blood test and ask you to change into a gown.
Before the procedure
Your nurse will bring you to the X-ray department on your bed. In the X-ray department you will be seen by a radiology doctor. This is an opportunity to discuss the procedure before you sign a consent form. Please ask any questions you may have as it is important that you understand what is going to happen.
During the procedure
In the procedure room you will lie on a special X-ray table. Your neck or groin will be cleaned with antiseptic fluid and you will be covered with a sterile drape. The doctor will give you an injection of local anaesthetic to numb the skin in your neck just by your collarbone or in your groin. This will cause some stinging initially and then go numb.
Throughout the procedure a nurse will monitor your pulse and blood pressure. Please let the nurse know if you feel any discomfort. The procedure should not cause you any pain.
The doctor will insert a catheter (fine plastic tube) into the vein in your neck or groin. The doctor will inject dye to highlight your veins and then take X-ray pictures to help guide the catheter into the right position.
Once the catheter is in the right position, the filter will be passed through the catheter and placed in your vein. We will explain what is happening throughout the procedure. The procedure will take about 45 minutes but may take longer.
After the procedure
After the procedure the doctor will press on the needle site for about 5 minutes to make sure it stops bleeding. A dressing will be placed over the site. You will need to rest in bed for 2 hours and the ward nurse will take your blood pressure and pulse regularly. If you feel unwell or are in any discomfort at any time, please tell your nurse.
Going home
You may be able to go home the same day as your procedure. This will be assessed by your doctor on the ward.
After you are home
- You must avoid driving on the day of your discharge
- You must avoid sport, excessive activity or lifting anything greater than 5 kg (11 lb) for the next 48–72 hours
- Avoid baths for 3–4 days or until the skin site is healed—you may only shower
- If you experience any discomfort, take regular painkillers
- You can remove the dressing after 24 hours—place a fresh plaster on the needle site each day until it heals
Contact information
Chelsea and Westminster Hospital
Interventional Radiology Department
1st Floor, Lift Bank D
T: 020 3315 8570/8582