Let's learn about the small device (Vena Cava Filter) that stops blood clots from reaching the lungs.

Sometimes, blood clots can form in the deep veins of our bodies, especially in the legs. If these break away from there, travel with the blood, travel through the heart, and get stuck in a vein in the lungs, it can be a very dangerous situation that can even be life-threatening. So today we are going to talk about a special, small device that is used for people who are at risk of this and who cannot take anticoagulants.

Simply put, what is this Vena Cava Filter?

This is actually a small metal device. Think of it like the frame of an umbrella, or a small mesh. It's placed inside a major blood vessel in our body. Its main function is to stop blood clots that form in the lower parts of the body from traveling up with the blood and going to the lungs. It's like a filter that's put in a water pipe to stop dirt. It allows the blood to flow through without any obstruction, and only catches the blood clots.

There are two main types of these filters:

• Inferior Vena Cava (IVC) Filter: This is the most commonly used. The Inferior Vena Cava is the main vein that carries blood from the lower part of our body (such as the legs and abdomen) to the heart. So, this filter is placed inside this vein to stop blood clots from forming in the legs.
• Superior Vena Cava (SVC) Filter: This is used very rarely. It is used if there is a risk of blood clots in the vein that carries blood from the upper part of the body (such as the arms, neck, or head) to the heart.

Who needs this IVC Filter?

A doctor may recommend an IVC filter for a few specific reasons. Not everyone who develops a blood clot will need one. You may want to consider one if you have one of the following conditions:

• If you have a condition where blood clots form in your veins, called Venous Thromboembolism (VTE) , and...
• If you cannot take anticoagulants, it may be because you have another medical condition that increases your risk of bleeding, or because you are allergic to the medication.
• If you are taking blood-thinning medication, but still have recurring blood clots .
• If you have previously developed or currently have a blood clot in a deep vein in your leg, i.e. Deep Vein Thrombosis (DVT) .
• If you have developed a pulmonary embolism , a blood clot in the lungs, and there is a high risk of it occurring again.

How is this surgery done?

This is not a major surgery. It can usually be completed in about an hour.

Before surgery

Your doctor will ask about your health history. You will need to tell them about all the medications you are taking. They may ask you to stop taking aspirin or blood thinners for a few days. They will also advise you to stop eating and drinking for a few hours before the surgery. They may also do blood tests, an ECG, and an echocardiogram.

During surgery

1. First, a saline (IV) will be placed in a vein in your arm.

2. I will give you a medicine to calm you down and make you feel a little dizzy.

3. A numbing medicine is injected into the area where the filter will be inserted (usually in the neck or groin).

4. Then, a very small incision is made, and a thin tube called a catheter is passed through it along the vein to the location of the Vena Cava.

5. The doctor will use a special X-ray technique (fluoroscopy) to check that the tube is in the correct place. He may also inject a special liquid (contrast material) to make the vein more visible.

6. Once in the correct location, the filter is inserted through the catheter and placed there. The filter opens up inside and attaches to the walls of the vein.

7. When the work is finished, the catheter is removed and the incision is closed with a bandage.

What are the risks and aftercare of the surgery?

After the surgery, you will need to stay in the hospital for a few hours. If you have any pain, you will be given painkillers. In most cases, you can go home the same day. But you will need someone to take you home.

Although this is a largely safe surgery, there are some risks that can occur very rarely.

• An allergy to the special fluid (contrast) injected.
• Bleeding or infection at the incision site.
• Damage to the blood vessel.
• Moving away from the filter insertion site and into the heart or lungs.
• Filter fracture .
• Blockage of the vein where the filter is placed (IVC thrombosis) .

These risks are very low, but it is important to be aware of them.

Recovery

The filter starts working immediately after insertion. There may be some bruising and discomfort at the incision site for a few days. If it was inserted through the neck, you can resume normal activities in about 24 hours. If it was inserted through the groin, the doctor advises you to avoid activities such as climbing stairs, driving, and lifting weights for about two days.

If it is a temporary (retrievable) filter, it is very important to remove it as soon as possible, once the risk of blood clots has decreased, or when blood thinners can be started. Because if the filter is left in the body for too long, the risk of complications we discussed earlier increases.

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