A Vena Cava Filter is a small, metal device about an inch long, shaped rather like the spokes of an umbrella. The filter is placed in the Vena Cava, which is the large vein in the abdomen that brings blood back from the legs and pelvis, towards the heart. If there are blood clots in the veins in the legs or pelvis, these could pass up the Vena Cava and into the lungs and cause severe illness or even death. The filter will trap these blood clots and prevent them entering the lungs and causing problems.

Usually you will be taking blood-thinning drugs, “anticoagulants”, which either have caused problems with bleeding or need to be stopped because of a planned operation. Sometimes blood thinning alone has not been enough and a filter is needed as well.

The consultant in charge of your case and the Interventional Radiologist inserting the Vena Cava Filter will have discussed the situation and feel that this is the best treatment option. However, you will also have the opportunity for your opinion to be taken into account and if, after discussion with your doctors, you do not want the procedure carried out, then you can decide against it.

A specially trained doctor called an Interventional Radiologist who has expertise in using x-ray equipment to guide treatments.

The procedure generally takes place in the Interventional Radiology department, in an “angiography” room.

You need to be an in-patient in the hospital. You will be asked to put on a hospital gown.  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 scanning, then you must also tell your doctor about this.

You will lie on the x-ray table, generally flat on your back. You may also have a monitoring device attached to your chest and finger.

The Interventional Radiologist will keep everything as sterile as possible and will wear a theatre gown and operating gloves. The skin near the point of insertion, probably the groin, will be cleaned with antiseptic and then most of the rest of your body covered with a theatre towel.

The skin and deeper tissues over the vein will be anaesthetised with local anaesthetic (see below) and then a needle will be inserted into the vein. Once the Interventional Radiologist is satisfied that this is correctly positioned, a guide wire is placed through the needle and into the vein. Then the needle is withdrawn and a fine plastic tube, called a catheter, is placed over the wire and into the vein. This catheter has the filter attached to it.

The Interventional Radiologist uses the x-ray equipment to make sure that the catheter and the wire are moved into the right position. The wire is then withdrawn and the filter can be released from the catheter and left in place in the Vena Cava.

The catheter will then be removed and the Interventional Radiologist will press firmly on the skin entry point for several minutes to prevent any bleeding.

Local Anaesthetic:

Your Interventional Radiologist will ask you to keep quite still while the injection is given.

You may notice a warm tingling feeling as the anaesthetic begins to take effect.

Your procedure will only go ahead when you and your radiologist are sure that the area is numb.

If you are not having sedation, you will remain alert and aware of your surroundings.

Your Interventional Radiologist is always near to you and you can speak to him/her whenever you want to.

You will be taken back to your ward on a trolley. Nurses on the ward 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 a few hours, until you have recovered. You may be allowed home on the same day or kept in hospital 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 half an hour, but you may be in the x-ray department for about an hour altogether.

Some discomfort may be felt in the skin and deeper tissues during injection of the local anaesthetic. After this, the procedure should not be painful.

You will be awake during the procedure and able to tell the radiologist if you feel any pain, or become uncomfortable in any other way.

Yes. 

If you are diabetic and take insulin, you may need a drip to keep your blood sugars controlled.  This will be discussed with you on the ward prior to the procedure (see next question also).

Yes - Metformin (Glucophage, Avandamet) is most commonly taken by diabetic patients to control blood sugar, but occasionally is taken for other conditions.

If you are taking Metformin, your preparation for the procedure may change.  Please ring our helpline telephone number, at the hospital you are attending, as below:

 Freeman Hospital: (0191) 223 1012       RVI: (0191) 282 5627

 and speak to a member of staff, who will be able to advise you. 

As discussed above, vena cava filters can be used instead of blood thinning.

Vena Cava Filter insertion is a very safe procedure, but there are some risks and complications that can arise. There may occasionally be a small bruise, called a haematoma, around the site where the needle has been inserted and this is quite normal. If this becomes a large bruise, then there is the risk of it getting infected and this would then require treatment with antibiotics.

Very rarely, some damage can be caused to the vein by the catheter and this may need to be treated by surgery or another radiological procedure. There is a possibility that the filter will actually cause some blockage of the Vena Cava, the large vein that brings blood back from the legs to the heart and because of this there may be some swelling of the legs. As with any mechanical device, there is also the possibility that the filter will eventually fail to work properly. Despite these possible complications, the procedure is normally very safe and is carried out with no significant side effects at all.

Your consultant will see you in clinic. Sometimes we will plan to remove the filter when it is no longer needed. This is done in the same way as the filter is inserted.

Some of your questions should have been answered above, but remember that, this is only a starting point for discussion about your treatment with the doctors looking after you. Please make sure you are satisfied that you have received enough information about the procedure, before you sign the consent form.

Insertion of a vena cava filter is considered a very safe procedure, designed to prevent the serious complications that can develop from blood clots. There are some slight risks involved and although it is difficult to say exactly how often these occur, they are generally minor and do not happen very often.

Should you have any suggestions or concerns, please make these known to the person conducting your examination or by letter addressed to the hospital that you are attending your examination:

The Departmental Manager            

X-ray Department Level 3                           

Royal Victoria Infirmary                               

Queen Victoria Road                                   

Newcastle upon Tyne                                  

NE1 4LP                                                       

Tel: (0191) 2821099

or:

The Departmental Manager

Main X-ray Department

Freeman Hospital

High Heaton

Newcastle upon Tyne 

 NE7 7DN

Tel: (0191) 2821099

Monday to Friday 8.30am to 5.00pm

All Newcastle Hospitals: Switchboard Tel: (0191) 233 6161 (24 hours)

The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS.  You can contact them on freephone 0800 032 02 02 or email northoftynepals@nhct.nhs.uk.

Information produced by: Dr Ralph Jackson, Clinical Directorate of Radiology

Reviewed: August 2012

Next Review: Sept 2015