Endovascular Thrombectomy/IVC Filter Replacement & Retieval
Endovascular thrombectomy is performed under imaging guidance by your physician. This procedure is designed to rapidly break up the clot, restore blood flow within the vein, and potentially preserve valve function to minimize the risk of post-thrombotic syndrome. The physician inserts a catheter into the popliteal (located behind the knee) or other leg vein and threads it into the vein containing the clot using imaging guidance. The catheter tip is placed into the clot and a "clot busting" drug is infused directly to the thrombus (clot). The fresher the clot, the faster it dissolves - one to two days. Any narrowing in the vein that might lead to future clot formation can be identified by venography, an imaging study of the veins, and treated by the physician with a balloon angioplasty or stent placement.
In patients in whom this is not appropriate and blood thinners are not medically appropriate, the physician can insert a vena cava filter, a small device that functions like a catcher's mitt to capture blood clots but allow normal liquid blood to pass.
In an inferior vena cava filter placement procedure, the physician uses image guidance to place a filter in the inferior vena cava (IVC), the large vein in the abdomen that returns blood from the lower body to the heart.
Blood clots that develop in the veins of the leg or pelvis, a condition called deep vein thrombosis (DVT), occasionally break up and large pieces of the clot can travel to the lungs. An IVC filter traps large clot fragments and prevents them from traveling through the vena cava vein to the heart and lungs, where they could cause severe complications or even death.
Until recently, IVC filters were available only as permanently implanted devices. Newer filters, called optionally retrievable filters, may be left in place permanently or have the option to be removed from the blood vessel later. This removal may be performed when the risk of clot travelling to the lung has passed. Removal of an IVC filter eliminates any long term risks of having the filter in place. It does not address the cause of the deep vein thrombosis or coagulation. Your referring physician will determine if blood thinners are still necessary.