IVC Filter Placement and Removal

How Does IVC Filter Placement and Removal Work?

At Houston Methodist, our internationally renowned vascular surgeons have vast experience with a variety of IVC filter removal techniques, including using robotic systems with advanced 3-D imaging, allowing our doctors to more easily evaluate IVC filters. 

Our surgeons at Houston Methodist Cardiovascular Surgery Associates consult with patients prior to both placement and removal of IVC filters, offering:

• Second opinions and advice about their IVC filters, responding to a nationwide call for patients to file lawsuits against filter manufacturers because of complications
• Consultation in filter complication management
• A variety of filter removal techniques, including robotic-guided removal

IVC Filter Success Rates

IVC filters are surgically implanted into more than 250,000 patients annually nationwide, our specialists estimate. These filters have been used for decades to prevent pulmonary embolisms, the passage of blood clots from the legs into the lungs. The placement of IVC filters is generally considered to be a straightforward and highly effective process. However, IVC filter retrieval may present an increased risk for potentially serious complications. 

In 2014, the FDA recommended filters be removed as soon as possible after implantation, ideally within 29 to 54 days in eligible patients. As a result, IVC filter removal is performed throughout Houston Methodist. 

In 2015, Alan Lumsden, MD, director of DeBakey Heart & Vascular Center, made history when he performed the world's first intravascular robot-assisted retrieval of an IVC filter at Houston Methodist Hospital. Since then, Houston Methodist has stood out as a leader in IVC filter retrieval, offering minimally invasive and highly effective procedures for safe and seamless IVC filter removal.

What Conditions Do IVC Filters Treat?

IVC filters are used as a treatment to catch potentially life-threatening blood clots before they can travel to the lungs. They are typically recommended for patients who cannot take anticoagulants or blood thinners, but who are prone to certain conditions, including:

Venous Thromboembolism

Venous thromboembolism or VTE is a somewhat common condition in which blood clots form in the veins. VTE can be caused by injury, infection or major surgery. A lack of movement after one of these events can contribute to the likelihood of developing VTE. Symptoms may not occur in some cases of VTE, while in others, patients notice redness, swelling, chest pain or shortness of breath.

Pulmonary Embolism

Pulmonary embolism (PE) is a type of VTE in which a blood clot, usually in the lower extremities, breaks off and travels to the lungs. Once there, it creates a blockage in the artery that can be fatal if not treated right away. Signs of PE include sudden shortness of breath, wheezing, rapid breathing or chest pain when inhaling.

Deep Vein Thrombosis

Deep vein thrombosis (DVT) is also a type of VTE in which a blood clot forms in the body’s deep veins, usually in the legs or arms. Early signs of DVT include redness, swelling and tenderness or cramping in the affected area. Your risk of developing DVT becomes worse with travel or long periods of time in which walking or moving around is not possible. If left untreated, DVT can turn into pulmonary embolism.

Recurring Blood Clots

Patients with VTE may be undergoing treatment for ongoing blood clots, including blood-thinning medications to support anticoagulation. However, some patients may find that this first-line treatment is not effective in preventing VTE and DVT. In these cases, IVC filter placement may be recommended to prevent blood clots from developing into pulmonary embolism.

Who Qualifies for IVC Filter Placement or Removal?

Patients who have been diagnosed with deep vein thrombosis are the most likely candidates for IVC filter placement. However, most physicians recommend treating DVT with anticoagulants first. But for some patients, blood thinners may prove ineffective, while others are not able to take them at all. For these patients, a vascular surgeon may recommend an IVC filter.

When it comes to IVC filter removal, the patient must have been implanted with a retrievable filter. The surgeon will determine whether the filter has been effective in catching blood clots, and assess whether the risk of developing more clots has passed. Most often, retrievable IVC filters are removed around 3-6 months after implantation.

Permanent filters may also be removed if there is a pressing reason to do so, though this does increase the risk of complications. If you have not followed up with your doctor within 60 days after the IVC filter was placed, we encourage you to contact your physician to determine a recommended plan of care regarding your IVC filter. 

Preparing for IVC Filter Placement or Removal

Patients with IVC filters must be evaluated regarding filter removal risks and benefits. Filter implantation is relatively simple, which may have contributed to its overuse. However, removal can be challenging and potentially hazardous. To be a candidate for this procedure, removal must be less risky than leaving a filter in place.

Because both IVC filter placement and removal are surgical procedures, the preparation for each may be similar, and may include:

• Fasting the evening before the procedure
• Stopping blood thinners or other anticoagulants like aspirin beforehand
• Arranging for someone to drive you home after each procedure
• Having blood tests prior to surgery to check coagulation and kidney function
• Notifying your physician of any allergies or sensitivities to latex, anesthesia or contrast dye

Recovering from IVC Filter Placement or Removal

While filter placement and removal are typically considered to be minimally invasive, you will still need to allow time to recover from each procedure. You may be asked to lie still for some time after the procedure, but you will usually be released to go home within a few hours. Upon returning home, most patients can resume light activity and a normal diet within the first 24 hours. Patients should avoid heavy lifting or strenuous exercise for a couple of days. Make sure to keep the incision site clean and dry, and monitor for signs of infection.

In the case of a complex IVC filter retrieval, the recovery may take a bit longer, and patients will need to be aware of signs of IVC thrombosis — the development of a blood clot inside the inferior vena cava, at or near the filter site. IVC thrombosis is a rare but dangerous condition that causes swelling and pain in both legs and pain in the abdomen. If it isn’t caught right away, it can lead to pulmonary embolism.

If you have any concerns after either an IVC filter placement or removal, contact your vascular care team right away.