Candidates for IVC Filters
The types of individuals who are due for the implementation of an IVC filter are:
- Patients who have developed a condition that puts them at risk for heavy bleeding
- Patients who are immobile
- Patients who are diagnosed with deep vein thrombosis
- Patients who are prone to developing large clots in the inferior vena cava
- Patients who have clots in the iliac veins
- Patients who are trauma victims
- Patients who have tried anticoagulant therapy and have been unsuccessful
Types of IVC Filters
Doctors usually only recommend this utensil in high risk scenarios, and it is not intended to be substituted for prescription drugs that aid in subduing and managing non-life threatening pulmonary emboli. These devices are solely used in patients who have had previous issues with being sufficiently anticoagulated – having the effect of inhibiting the blood from changing from a solid to a semisolid state. In most instances, a patient’s doctor will propose which type of filter would prove to be most useful and effective for the patient. The types of IVC filters available for patient’s consist of permanent IVC filters and retrievable IVC filters.
Permanent IVC Filters
Deemed as the standard type of filter, permanent IVC filters were made specifically for patients who experience ongoing issues with blood clots. Patients who have these filters permanently implemented into them frequently schedule follow up appointments with doctors to monitor their condition, and keep them updated about symptoms the filter could potentially cause.
Permanent IVC Filter Manufacturers Cleared by the FDA:
- Bird’s Nest
- Simon Nitinol
- Vena Tech LGM filter
- Titanium Greenfield filter
- TRAPEASE filter
Retrievable IVC Filters
Retrievable IVC filters, also known as temporary filters, are designed to only be utilized for a short time. Filters were originally meant to stay in a patient’s body once embedded, but recently manufacturers have decided to create another option. Most surgeons implant these filters when clots begin to develop and remove them when the risk for a pulmonary embolism has seemingly diminished. Generally, there’s a limit on the time a filter can remain implanted into a patient. Most manufacturers usually only recommend that the filter reside in the body for up to three months, however, they have been cleared by the United States Food and Drug Administration for permanent placement.
Retrievable IVC Filter Manufacturers Cleared by the FDA:
- C.R. Bard IVC Filters
- Cook Medical IVC Filters
- Rex Medical IVC Filters
As mentioned earlier, the insertion of an IVC filter is an endovascular procedure, which means that the filter is implanted through a blood vessel. It’s standard for surgeons to use the internal jugular vein in the neck, or the femoral vein the in groin. As with most procedures, patients are provided with an anesthetic to numb the area. Surgeries involving IVC filters usually numb the skin surrounding the skin where the catheter will be inserted. Patients are required to be sedated, but will still be coherent throughout the surgery. From there, the vascular surgeon will thread a guide wire through a needle inserted in the neck or groin with a contrast dye attached. Simultaneously, x-rays will identify the dye within a patient’s body, allowing the IVC filter to advance along the guidewire to the location of the placement. The filter is pushed through the catheter and placed in its proper location, after successfully doing so, the catheter is removed. Once the filter is implemented, patients are prohibited from smoking and eating fatty foods that will raise their cholesterol levels. They will also be expected to exercise and attend scheduled appointments to minimize complications.
For every medical procedure and treatment there are potential risks involved, but IVC filter placement has been associated with many complications.There have been several reports of issues occurring during the implementation of IVC filters, the duration of time within the body, and removal. Some short term risks are ones seen with any medical procedure executed via needle-puncture of the skin, such as abnormal heart rhythm, collapsing or expansion of the lungs, infection at the insertion site, an allergic reaction to the anesthetic or x-ray dye, a damaged vein and kidney failure. However, other complications that are directly associated with the filter include an incomplete opening, abnormal bends or curve in an organ, misplacement, blocked blood flow to the filter, an escaping pulmonary embolism and death. Long term complications consist of an increased risk of subsequent deep venous thrombosis (DVT), vena cava stenosis, wire entrapment, filter migration, or injury to the neck or groin where the catheter was inserted.
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