Monday, May 18, 2015

How To Perform An IVC Filter Placement

IVC filters can be placed surgically but the vast majority are placed percutaneously.

Pre Procedure

  • Indications
    • New clot or clot progression on therapeutic anticoagulation.
    • Pre-op for patient who cannot be anticoagulated
  • Can be placed from a transjugular or transfemoral approach.
  • Ideal location is infra-renal.
  • Make sure to check a CT beforehand for variant renal vein anatomy.


  • Access the venous system either via a jugular or femoral approach. If femoral, the vein is 1 cm medial to the artery.
  • Insert a Pig cava catheter, and perform an angiogram (Usually 15 ccs / min for 30 cvs)
  • Exchange the catheter for the filter sheath, after dilation of the tract.
  • Gunther-Tulip Jugular
    • Insert the filter until the feet are at the end of the sheath. Unsheath the filter. Press the button to deploy.
  • Gunther-Tulip Femoral
    • Insert the filter until the tip is at the end of the sheet. Unsheath the filter. Bring the red and white torquers together and twist to deploy.
  • Option
    • Make sure the correct end is facing the catheter

Post Procedure

  • If retrievable, can be retrieved up to 3 weeks before the filter epithelializes
  • Complications: fragmentation, migration, perforation

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