This information leaflet has been produced to give you general information and hopes to answer most of your questions when requiring a Vena Cava Filter insertion. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have concerns or require further explanation, please discuss this with a member of the healthcare team.
What is a Vena Cava Filter?
A Vena Cava Filter is a small metal device shaped like an umbrella. The filter is placed into the large vein in your abdomen (tummy) called your vena cava. If there are blood clots in the veins in the legs or pelvis these may be caught by the filter and reduce the risk of any clots entering your lungs.
Why do I need this procedure?
There are a number of reasons why people need a vena cava filter.
You may need a filter to reduce the risk of clots entering your lungs whilst you are having or recovering from surgery.
You may have had other tests that show you have blood clots in your blood vessels. Generally these are dealt with by using blood thinning drugs, but in your case it may be that these drugs are not suitable and a filter is an alternative way of reducing the risk of these blood clots travelling to your lungs and causing you a more serious problem.
How do I know if this is a suitable procedure for me?
Your doctor and the Radiologist (a doctor who specializes in reading images) have discussed your symptoms and will discuss with you the reasons why they want you to have the filter inserted and your opinion will be taken into account. If after further discussion you do not want the procedure to be carried out, then you can decide against it.
You will usually need to attend the radiology pre-assessment clinic to establish your general health.
At this appointment you will need to have your blood pressure measured, a heart tracing performed and blood samples taken. A nurse will talk to you about the investigation. You will also be asked to give your consent for the procedure to go ahead following a detailed discussion with a radiologist or senior nurse. There will be plenty of time during this appointment to answer your questions.
There is currently no alternative to this procedure. If your doctors have asked for this filter to be inserted then anti-coagulation (blood thinning) medication such as Warfarin is either unsuitable or inadequate.
Who will insert the filter?
A radiologist or a senior radiology nurse who have the special skills and training that is needed to insert the filter. X-ray pictures of the inside of your veins are taken whilst carrying out the procedure to make sure the filter is in the right place.
Can I take my medication as normal?
Most medication can be taken as normal. If you are taking Metformin or any anti-coagulation (blood thinning) medication, it is important that you let us know at your pre-assessment appointment.
What happens during the procedure?
On the ward
The procedure is usually a day case, but occasionally an overnight stay is required. You will be asked to go to a ward for a couple of hours to prepare before the procedure. On the ward you will be asked to put a hospital gown on and a cannula (plastic needle) will be inserted into one of your veins. You can continue to eat and drink normally.
In the x-ray department
A nurse will complete a checklist with you before leaving the ward. The procedure is performed in the x-ray department. On entering the x-ray room a radiologist (x-ray doctor), radiographer (person who takes the x-ray pictures) and a nurse will greet you. They will check your personal details and discuss the procedure with you, including where they will access the vein (access site).
You will be asked to lie flat on the x-ray table with a pillow under your head. You will be awake during the procedure and there will be a member of staff nearby at all times to support you. Your blood pressure, oxygen levels and heart rate will be measured regularly.
During the procedure
The skin above the access site to the vein will be cleaned (this is usually your neck but can be your groin and will have been discussed with you at your pre assessment appointment) and some local anaesthetic will be injected into the skin. The local anaesthetic will make this part of your body go numb. You may feel a little pressure as a thin catheter (tube) is placed into the vein. The doctor/senior nurse will then use x-rays to see the position of this catheter. Contrast (x-ray dye) is injected through the catheter. X-rays will be taken at the same time and will show the vein where the filter is to be placed.
As the x-ray dye enters the veins, you may feel a warm sensation. It may feel as if you urgently need to pass urine, but this is only a feeling, it is normal and will pass quickly.
The doctor/senior nurse will now decide the position to place the filter and pass the filter through the catheter that is in place. The doctor/senior nurse will inject some more x-ray dye and take x-rays to confirm the position of the filter, following which the catheter is removed and some pressure applied over the access site whilst bleeding stops. A small plaster is applied to the skin.
What happens after the procedure?
You will be helped back onto a trolley. There will be someone with you until the ward nurse arrives to escort you back to the ward.
A nurse will observe your access site regularly and continue to measure your blood pressure, oxygen levels and heart rate. If you feel any swelling, oozing or pain in the area of the access site, please inform the nurse immediately.
You will still be allowed to eat and drink after this procedure. It is important to drink plenty after this procedure to help your kidneys flush the x-ray dye from your body.
If you need to use the toilet during this time, please ask for a bedpan or bottle.
If your doctors decide that the filter needs removing in the future they will ask the x ray department to do this.
If you have come into hospital only to have the filter inserted you are normally able to go home the same day.
Are there any risks?
Vena Cava Filter insertion is a safe procedure but all procedures carry some risks.
Minor risks:
Sometimes there is a bruise at the access site.
Major risks:
Very rarely some damage can be caused to the vein by the tube and this may need treatment by surgery.
There is a possibility that the filter will cause some blockage to the vena cava vein. This could result in swelling to the legs.
Very rarely air can get trapped in the vein (air embolus). The radiologist or senior nurse performing the procedure will discuss all the risks and benefits with you before you have the procedure.
How soon will I be back to normal?
After you have had two hours in bed you can start to mobilise again, providing that you are feeling well. After this time you can return to your normal activities. You may feel a little bit tender for the first few days in the area that the filter was passed through. There are no restrictions to driving after this procedure.
What happens if I decide not to have the procedure?
You will be referred back to the doctor who recommended the vena cava filter insertion to discuss it further.
What if I have any special requirements?
If you have any special needs or requirements please discuss this with the nurse at your pre-assessment visit or contact the radiology nurses on the number below.
Where can I get more information?
Radiology nurses can be contacted on:
0191 445 3260 or 0191 482 0000 hospital switchboard and ask for bleep 2687
Monday to Friday 9am to 5pm
NHS 111
If you require advice outside the above hours after you have had the vena cava filter inserted then please contact your General Practitioner.
Data Protection
Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.
In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics. Further information is available via Gateshead Health NHS Foundation Trust or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email [email protected].