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This page tells you about having an inferior vena cava (IVC) filter removal. It explains what is involved and what the possible risks are. It is not meant to replace an informed discussion between you and your doctor but can act as a starting point or reminder for such discussions. If you have any questions about the procedure please ask the doctor who has referred you or the department which is going to perform it.
Your procedure will take place in the Radiology department. The radiology department may also be called the ‘X-ray’ or ‘Imaging’ department. It is the facility in the hospital where radiological examinations are carried out, using a range of x-ray equipment, such as a CT (computed tomography) scanner, an ultrasound machine and a MRI (magnetic resonance imaging) scanner.
Interventional Radiologists are doctors specially trained to carry out imaging guided complex procedures. They are supported by radiographers who are highly trained to carry out x-rays and other imaging procedures. Also specialist nurses who are highly trained in interventional procedures, sedation, recovery and patient support.
An IVC filter is a small metal device (about an inch long body, shaped rather like the spokes of an umbrella) usually placed in the large vein called the inferior vena cava (IVC) that drains blood from the legs. The IVC filter allows blood to flow through normally but traps any large blood clots, stopping them from travelling to your lungs.
Blood clots (thrombosis) sometimes form in the veins of the legs and pelvis. They are known as a deep vein thrombosis (DVT). The clot can break free and enter the blood stream flowing into the lungs. This is called pulmonary embolism (PE). They can be fatal if not detected and treated.
An IVC filter prevents a large PE by trapping the clot before it reaches the lungs.
The usual treatment for DVT and PE is drug treatment to thin the blood. This is usually with warfarin tablets. In a few patients, warfarin does not prevent further PEs, in others thinning the blood is too risky. When this happens, patients are considered for treatment by inserting an IVC filter.
Often, a patient is advised to have an IVC filter inserted before undergoing long surgery when their surgeons consider them at high risk of developing DVTs and/or PE’s. Patients are advised to have an IVC filter inserted prior to such surgery. These filters are generally removed about one to two months after surgery.
Your doctors will explain the reasons why they think you should have an IVC filter.
Modern IVC filters can be left in permanently; however, it is becoming more common for these devices to be a temporary solution and removed when they are no longer required. This is often at three months but may occasionally be longer.
If the Interventional radiology department has not contacted you regarding removing the IVC filter, then it is important that you contact your referring team for them to arrange with interventional radiology to remove it.
You need to be come to the Imaging Department at the time instructed on your appointment letter. You will be asked not to eat for six hours before your appointment time, though you can continue to drink clear fluids up to two hours prior to your appointment. Please take all your medication on the morning of the procedure unless you have been informed to miss it by your doctor or the Imaging department.
On arrival you will be checked into the department by a nurse. The nurse will fill in some paperwork and do some clinical observations-like blood pressure and pulse. The Radiologist will come and explain the procedure and sign off the Consent form with you. This is where you have the opportunity to talk to the Radiologist doing your procedure and they will be able to address any concerns you may have.
You will be asked to put on a hospital gown. The procedure is carried out using the big vein in the neck. (Very occasionally a large vein in the groin is used instead. If this is the case you will be informed. The skin in this area may have to be shaved.)
This procedure is commonly performed under local anaesthetic, however if you are expecting sedation, it is necessary that you have an escort to take you home and stay with you overnight. This is the policy for sedation, so please ensure you can make the necessary arrangements.
If you have any allergies, you must let your doctor know. If you have previously reacted to intravenous contrast medium (the dye used for kidney x-rays and CT scans), then you must also tell your doctor about this.
We need to know the clotting status of your blood before the procedure.
Please inform us if you are taking any of the following:
- Warfarin
- Sinthrome
- Rivaroxaban
- Dabigatran
- Apixaban
Or any other medication to thin your blood.
IVC filter removal is a very safe procedure. Serious complications are very rare. There may be a small bruise at the needle site and very rarely there may be damage to the vein or blockage of the inferior vena cava. Occasionally the filter may have changed position, which can make it harder to retrieve.
We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with procedure, by law we must ask for your consent and will ask you to sign a Consent form. This confirms that you agree to have the procedure and understand what it involves.
The consent form is a form that both you and the operating doctor sign confirming that you have discussed the procedure and been informed of the risks/benefits/alternatives and have agreed to carry on with the interventional procedure. (You can have a copy of this form to take with you.)
Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish.
You will lie on the X-ray table, generally flat on your back. A needle will be inserted into a vein in your arm, so that a sedative or painkillers can be given if required (This is generally not needed as the procedure is usually tolerated very well with just a local anaesthetic). You may have monitoring devices attached to your chest and finger and may be given oxygen.
The procedure is performed under sterile conditions and the interventional radiologist and radiology nurse will wear sterile gowns and gloves to carry out the procedure. The skin near the
point of insertion, usually the neck but occasionally the groin, will be swabbed with antiseptic and you will be covered with sterile drapes.
The skin and deeper tissues over the vein will be numbed with local anaesthetic. A fine tube (catheter) will be inserted under ultrasound and x-ray guidance into the correct position. Small amounts of dye (contrast agent) are used to check the position of the filter. A removable IVC filter has a small hook at one end that enables the catheter to capture the filter, close it and pull it up into the catheter and then withdraw it from the body. Occasionally, it is not possible to remove a retrievable filter, particularly if there is still some blood clot caught within it.
The Radiologist will press firmly on the skin entry point for several minutes to prevent any bleeding.
Some discomfort may be felt in the skin and deeper tissues during the injection of the local anaesthetic. After this, the procedure should not be painful. There will be a nurse, or another member of clinical staff, standing nearby looking after you. If the procedure does become uncomfortable they will be able to arrange for you to have a painkiller through the needle in your arm. As the dye, or contrast medium, passes around your body, you may get a warm feeling, which some people can find a little unpleasant.
If sedation is required during the procedure, this will be explained to you prior to the start of the procedure. The Trust sedation policy states that if sedation is required, then the patient must ensure they have an escort arranged to escort them home and stay with them overnight.
Every patient’s situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be. Generally, the procedure will be over in about an hour.
You will be taken to the recovery area on a trolley. A recovery nurse will carry out routine observations, such as taking your pulse and blood pressure, to make sure that there are no problems. They will also look at the skin entry point to make sure there is no bleeding from it.
You will generally stay in bed for about an hour, until you have recovered. The nurses will let you know when they are happy for you to be discharged from recovery. You will be allowed to go home after this but will need someone to escort you. You will need to take it easy for the rest of the day but you can resume normal activities the next day.
Some of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Make sure you are satisfied that you have received enough information about the procedure.
Contact:
British Society of Interventional Radiology: www.
For general information about radiology departments, visit The Royal College of Radiologists: www.
NHS Direct
For health advice or information, you can call NHS Direct on 0845 45647 or visit the website: www.
The NHS Clinical Knowledge Summaries website: www.
UCL Hospitals cannot accept responsibility for information provided by other organisations.
Please contact the Clinical Nurse Specialist (CNS)
Direct line: Interventional radiology CNS: 0797 487 5629
UCH Switchboard: 020 3456 7890
Address:
Interventional Radiology Imaging Department
University College Hospital
2nd Floor
235 Euston Road
London
NW1 2BU
Admin Queries Email: uclh.
Radiology Admin enquiries phoneline: 020 3447 3267
Website: www.
Procedures:
The Imaging Department, Level 2 Podium in the main University College Hospital building with the entrance on Euston Road (see map).
Travelling to the hospital
No car parking is available at the hospital. Street parking is limited and restricted to a maximum of two hours.
Please note the University College Hospital lies outside, but very close to the Central London Congestion Charging Zone.
Tube
The nearest tube stations, which are within two minutes’ walk are:
▪ Warren Street (Northern and Victoria lines)
▪ Euston Square (Hammersmith & City, Circle and Metropolitan lines)
Overground trains
Euston, King Cross & St Pancras and Kings Cross Thames link railway stations are within 10-15 minutes’ walk.
Bus
Further travel information can be obtained from http://
Hospital transport service
If you need (and are eligible for) transport, please call:
020 3456 7010 (Mon to Fri 8am-8pm) to speak to a member of the Transport Assessment Booking Team.
If you have a clinical condition or mobility problem that is unlikely to improve you will be exempt from the assessment process. However, you will still need to contact the assessment team so that your transport can be booked. If your appointment is cancelled by the hospital or you cannot attend it, please call 020 7380 9757 to cancel your transport.
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Page last updated: 20 June 2024
Review due: 01 June 2026