Deep vein thrombosis, commonly called DVT, is a blood clot that forms within the veins in either the arms or legs, but usually within the legs. DVTs can cause complications locally, where a clot that sits within the vein that may cause scarring of the vein through a process called post-thrombotic syndrome. More concerning is if the clot increases in size and breaks away from the vein, traveling to the lungs, called a pulmonary embolism, where it may be fatal.
"The only way to address a clogged IVC filter is with surgical removal and repair of the vena cava. " - Dr. Edward Mackay
Treatment for DVT with IVC Filters
There are 2 types of treatments available for DVTs:
- Anticoagulants: A type of medication that thins the blood, prevents clot formation, and reduces the size of existing clots. There are many different types of anticoagulants that are available through prescription only and may require close monitoring.
- IVC filters: An IVC filter is an inferior vena cava filter. The vena cava receives blood from all other veins in the body to push the blood to the heart and lungs to receive oxygen This is a type of metal mesh-like device that is surgically placed in the inferior vena cava that blocks any blood clots from travel through the vena cava to the lungs.
With the concern for pulmonary embolisms, DVTs are usually treated aggressively. The main treatments are medications to thin the blood, called anticoagulants, or a filter that is placed within the vena cava, called an IVC (inferior vena cava) filter. The vena cava is the largest vein in the body and collects all the deoxygenated blood from the body to return it to the heart. The vena cava is divided into an upper and lower portion, the superior and inferior vena cava. The inferior vena cava receives blood from the legs, pelvis, and abdomen.
"The filter acts to block any clots that have broken away, to prevent pulmonary embolisms."
When are IVC Filters Used?
IVC filters are not used routinely, but there are specific circumstances for which IVC filters are a better option than anticoagulant management. For patients that have had recent surgeries or in specific have had brain surgery, the risk for bleeding with anticoagulants is much more dangerous than treating blood clots. In this case, an IVC filter may be placed to trap any blood clots. For patients that are already taking anticoagulants at an appropriate dosage and still have problems with DVTs, an IVC filter may be placed as a secondary treatment.
IVC filters should be used for a short duration, such as several months to 1 year. In the past, IVC filters were placed and left in the body for many years. Oftentimes, IVC filters were used as a preventative for blood clots for specific type of surgeries, hence why they were left in place for many years without removal.
The Problem with IVC Filters Clogging
The problem now is that overtime, the filter may become blocked with clots and prevent adequate blood from returning to the heart. Many patients may not be aware that they are developing a blockage at their filter site. Other patients may complain about leg swelling, pain, and fatigue.
For those patients that have an IVC filter in place for years, or those that are now experiencing symptoms of a possible blockage of the filter, the treatment is surgical removal. Based on the type of filter, the surgery may be easier or more difficult for removal. Besides just having a blockage of the filter, the filter may migrate, disrupt surrounding organs, or the filter may be damaged with a crack. The vena cava may need to be repaired once the filter is removed.
Is an IVC Filter Right For You?
IVC filters can be dangerous and lead to a need for surgical removal. When planning for placement of an IVC filter, please understand the potential complications and avoid having the IVC filter in place for too long of a duration. If you have concerns for an IVC filter that you have had for a long duration, please speak with your doctor to learn more and have the appropriate procedure performed to have the IVC filter removed.
Just because IVC filters can treat and prevent DVTs does not mean it is always a recommended treatment or a treatment that should be continued for long durations due to the potential complications. Speak with your doctor if you have an IVC filter in place, are considering an IVC filter, or you want to learn more about IVC filters.
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