We recently had a 50 year old gentleman who developed leg pain – a cramping, nagging pain. He then went on to develop a cough and shortness of breath. He went to the hospital and was found to have a “Pulmonary embolism”.
He was placed on blood thinners, but then developed blood in his urine and hence had to be taken off the blood thinners. So to protect his lungs and heart from further bad effects of these “clots”, an IVC filter had to be placed. Once done, his life was no longer at risk from these clots.
The procedure was done successfully through minimally invasive means under local anesthesia and he returned back to his room within 15 minutes.
A Pulmonary Embolism is a condition when a clot, typically from the leg, moves to the lungs and blocks the blood from flowing into the lungs from the heart.
This causes the heart to have to work harder to push the blood to the lungs and this can cause the right side of the heart to fail. This is the worry with blood clots or as they are more commonly known – DVT (Deep Vein Thrombosis).
Typically the clot in the leg (DVT) – can be prevented from “moving” (going to the lungs), with the use of blood thinners (anticoagulation). There are many newer medications, which are now easier to use (http://www.vascular.ae/vascular-dubai-uae-blog/new-anti-coagulants-blood-thinners/)
However some patients are not able to tolerate blood thinners, with bleeding from different parts of the body while on these medications, or if the clot happened soon after major surgery, in which case they would be at high risk of bleeding from the operation sites. Such patients are candidates for an “IVC (inferior vena cava) filter.”
An IVC filter is like an umbrella, which stops the clot from moving to the lungs, but DOES NOT stop clot formation – simply reduces the clots moving to the lungs.
Most IVC filters these days are removable, after the acute episode; whereas in the years gone by we used to leave these inside the body.
Placement of an IVC filter can be done under local anesthesia only with minimal to no discomfort and quick return to prior functionality.
Please remember, MOST patients do NOT require an IVC filter. It is this judgment of when it is needed and not just the skill of placing it, which the vascular surgeon needs to be consulted for.