Interventional Radiology :: Procedures :: Vascular :: IVC Filters
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Procedures Vascular IVC Filters
 
About the Procedure

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 The chances of pulmonary embolism is high once extensive DVT is established and a thrombus is seen to extend into the pelvic veins or the inferior vena cava then. At times it is seen that patients continue to have embolism even after treatment with blood thinners are given. There is another group of patients in whom blood thinners cannot be given since it may promote bleeding. Further, patients who are expected to be bedridden for a long time may not respond to blood thinners. All these patients carry a high risk of fatal pulmonary embolism and will benefit by implantation of a umbrella-shaped device which filters the blood as it passes through it. This device is called an IVC filter.

Procedure Details

 There are two sets of blood vessels in the human body. The arteries which supply blood from the heart and the veins which bring back  blood. The veins of the lower limb are  divided into two groups-the superficial and deep. The deep venous system can at times get completely blocked by blood; this condition is called DVT [deep venous thrombosis].

DVT can develop because of two conditions

1. Disorders of blood clotting

2. Stagnation of blood as seen in being bedridden for example after a major surgery, head injury or stroke. It can also be seen on sitting or standing for a long time like during a trans-Atlantic flight.

Complications of DVT

The mostly  dangerouscomplication of DVT is pulmonary embolism. The clotted blood in the veins at times fragment and get dislodged. These fragments  flow along the flow blood and enter the heart. From the heart it travels into the lungs through the pulmonary artery. When these fragments are small they hardly produce any symptoms at all. However, when they are large they can block a major vessel to the lungs. This results in sudden collapse secondary to reduction in the oxygen supply to the blood. In addition the pressure within the pulmonary artery arises rapidly leading to heart failure.

There are several treatments that are available to manage pulmonary embolism. However, the morbidity and mortality of massive pulmonary embolism continues to be high.

Prevention of pulmonary embolism

The chances of pulmonary embolism is high once extensive DVT is established and a thrombus is seen to extend into the pelvic veins or the inferior vena cava then. At times it is seen that patients continue to have embolism even after treatment with blood thinners were given. There is another group of patients in whom blood thinners cannot be given since it may promote bleeding. Further, patients who are expected to be bedridden for a long time may not respond to blood thinners. All these patients carry a high risk of fatal pulmonary embolism and will benefit by implantation of a umbrella-shaped device which filters the blood as it passes through it. This device is called an IVC filter.

Technical details

An IVC filter is is placed normally under the renal veins [ veins that come from the kidneys] however if the thrombus is seen to extend into the inferior vena cava it can also be placed above the renal veins. It generally comes preloaded in the small tube. which is called a catheter. This tube is inserted under image guidance through a small puncture in either the vein of the thigh or the  . The procedure is monitored under fluoroscopy [x-ray imaging] and the position is confirmed after injection of dye and delineating the IVC and the renal veins. The procedures performed under local anesthesia and takes approximately 30 minutes to complete.

 

Patient's after IVC filter implantation can undergo an MRI scan since the filters today are all compatible .

Complications

Complications are extremely rare in this procedure however, filter migration, occlusion and fragmentation has been described in the literature.

 Retrievable filters

In several occasions  clotting of blood vessels is secondary to a problem other than a clotting disorder, for example a patient, hospitalized for a major surgery who develops  DVT has a low risk of developing this problem once he's discharged and walking. In this category of patients a temporary filter would be the preferred choice. The procedure is similar to that of a permanent filter however, the filter can be removed in the first 3 months after implantation thus removing the metal in the vessel and reducing the small risk of  thrombosis of the filter in the future however small the risk may be.

For Further Information

contact:

email: dr.mathewcherian@gmail.com

mob :9600900373

office : 0422 2628627

 
 
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