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.

Procedure

• 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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