Inferior Vena Cava (IVC) Filter in Cyprus
Inferior Vena Cava Filter (IVC) placement is a procedure in which Dr Zertalis uses ultrasound (US) and X-Rays (Fluoroscopy) to insert a small metal device (filter) in a large vein in your abdomen called the inferior vena cava (IVC).
Blood from your legs and abdomen returns to the heart via the Inferior Vena Cava (IVC). By placing the filter in the IVC, large blood clots that have formed in the legs are prevented from travelling to the lungs without the filter disrupting normal blood flow.
Benefits
Deep Venous Thrombosis (DVT) describes the formation of blood clots (thrombus) in the veins of the legs and pelvis. A significant complication can sometimes occur when the blood clot detaches and travels from the veins in the leg and pelvis through the IVC to the blood vessels supplying the lungs. This is known as pulmonary embolism (PE) and can be life-threatening.
DVT and PE are predominantly treated with medication that thin the blood (anticoagulants) such as warfarin. There are cases however where anticoagulants cannot be used for treatment either:
- Due to an unacceptable risk of future complications from thinning the blood or
- Because a patient developed a new DVT or PE while already on treatment with anticoagulants.
In this instance, Inferior Vena Cava (IVC) filter placement is indicated.
Uncommonly, an IVC filter placement is indicated in a patient before surgery or after significant trauma. Dr Zertalis will discuss this with you in detail depending on which scenario applies to you.
Risks
IVC Filter placement is a safe, effective and accurate procedure, but as with any medical procedure there are some risks and complications that you may uncommonly experience.
Bleeding: Risk of significant bleeding is rare although this can occur by injuring structures (arteries) while attempting access to the veins. Small volume of bleeding and bruising where incisions are made may occur.
Infection: Insertion of the filter requires direct access to the bloodstream hence there is a very small risk of infection.
Filter Migration: The filter may have to be repositioned if it moves out of place although this is rare.
Filter & MRI: If there is a plan for you to have an MRI scan while you have the filter in place, please inform the team performing the scan in order to ensure that it is safe to do so.
Allergy to contrast (X-ray dye): Most adverse events are mild and can be managed safely in our department. A major life-threatening contrast reaction is rare (< 0.005%).
Radiation Risk: Immediate harmful effects such as skin burns, or radiation sickness are extremely rare. The radiation dose you receive during the procedure is monitored to prevent this. On rare occasions the procedure will have to be stopped if the threshold for immediate harmful effects is reached. Increase in lifetime risk of cancer due to radiation per examination is also rare (< 0.001%).
Dr Zertalis will explain the procedure and ask you to sign a consent form. 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.
Before the procedure
The procedure is performed under local anaesthetic and with sedation if necessary. You will be asked not to eat or drink for 6 hours before the procedure. Where necessary a blood test may be required. A short and thin plastic tube (cannula) will be placed into a vein in your arm.
Please let Dr Zertalis know about any medications you take, any allergies you may have and if you previously have had a reaction to the x-ray dye (contrast).
The procedure
You will be asked to change into a hospital gown and lie on your back. You will have devices attached to your chest, arm and finger to monitor you pulse, blood pressure and oxygen levels. You will be given a sedative to relieve anxiety and painkillers where necessary. This is standard for all minimally invasive interventional radiology procedures performed in Cyprus.
The procedure is performed under sterile conditions and Dr Zertalis will wear sterile gowns and gloves. Your skin will be swabbed with antiseptic and you will be covered with sterile drapes.
Following an injection with local anaesthetic, a small cut (incision) is made in the skin and Dr Zertalis will use ultrasound (US) and X-Rays (Fluoroscopy) to navigate a fine needle into a vein either in the neck or the groin to access the bloodstream.
Small volume of x-ray dye (contrast) will be used to define the anatomy of your Inferior Vena Cava (IVC) and associated blood vessels. You may experience a warm feeling in your abdomen during the injection – this is normal. The filter is placed in the IVC and is held in position against the wall of the IVC by small anchors.
Every patient is different, however, expect to be in the radiology department for up to 1 hour.
After the procedure
You will be transferred to your ward where your pulse, blood pressure, oxygen levels and the entry site in the skin will be checked by our team at regular intervals. You should expect to be in bed for up to 6 hours until you have recovered and are ready to go home. Temporary IVC Filters are removed when no longer required and this is often two to three months after your procedure.
