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IVC Filter Placement In Mumbai
Minimally Invasive Protection Against Pulmonary Embolism for High-Risk Patients
An IVC (Inferior Vena Cava) filter is a small metal device placed inside the inferior vena cava - the large vein that returns blood from the legs and pelvis to the heart and lungs - to trap blood clots and prevent them from reaching the lungs and causing a life-threatening pulmonary embolism (PE). At Shree Hospitals, our specialist interventional radiologists place IVC filters as a minimally invasive catheter-based procedure under X-ray image guidance for patients with deep vein thrombosis (DVT) who cannot receive anticoagulant (blood-thinning) medication.
Blood Clot Diagnosis and Cannot Take Blood Thinners? Ask About IVC Filter Today
Quick facts
Device Type : Retrievable or Permanent IVC Filter
Anaesthesia : Local Anaesthesia (no general anaesthesia required)
Duration : 30 to 45 minutes
Hospital Stay : 1 day (or as required for underlying condition)
Recovery Time : Immediate; patient mobilises same day
Support Team : Interventional radiologists, haematologists, vascular surgeons
Key Benefit : Prevents pulmonary embolism when anticoagulation is contraindicated
What is IVC Filter Placement?
The inferior vena cava (IVC) is the largest vein in the body, carrying blood from the lower limbs and abdomen back to the right side of the heart. Blood clots (thrombi) forming in the deep veins of the legs or pelvis (deep vein thrombosis, DVT) can break off and travel through the IVC to the lungs, where they cause a pulmonary embolism (PE) - a potentially fatal blockage of the pulmonary arteries. The standard treatment for DVT is anticoagulation (blood-thinning medication) which prevents further clotting. However, some patients cannot take anticoagulants safely due to bleeding risk. For these patients, an IVC filter provides a physical barrier that traps clots before they reach the lungs.
An IVC filter is a small metal device (resembling a small wire cage or umbrella) that is positioned within the IVC just below the level where the renal veins enter. It is placed through a narrow catheter inserted via a small puncture in the jugular vein (neck) or femoral vein (groin) under fluoroscopic X-ray guidance - no surgical incision is needed. Once deployed, the filter sits against the wall of the IVC and allows normal blood flow to pass through while trapping any large clots that travel up from the legs. Modern retrievable filters can be removed percutaneously once the bleeding risk resolves and anticoagulation can be safely started.
At Shree Hospitals, IVC filter placement is performed by our interventional radiology team as an urgent or elective procedure using advanced fluoroscopic guidance with intraprocedural cone-beam CT to confirm precise filter positioning below the renal veins. We use retrievable IVC filters in all patients where eventual retrieval is anticipated, to reduce the long-term complications associated with permanent filters (IVC thrombosis, filter fracture, filter migration). Our team also performs IVC filter retrieval when anticoagulation becomes safe, using advanced endovascular retrieval techniques including loop snare and forceps methods.
Who Is a Candidate for IVC Filter Placement?
IVC filter placement is indicated for:
- DVT or PE in patients with a contraindication to anticoagulation - including recent major surgery, active bleeding, intracranial haemorrhage, thrombocytopenia (very low platelet count), or recent trauma
- Recurrent PE despite adequate anticoagulation (filter as an adjunct to anticoagulation)
- Patients undergoing major surgery with high DVT and PE risk who cannot be anticoagulated in the peri-operative period (prophylactic filter)
- Patients with massive free-floating DVT thrombus at high risk of large PE during the initial anticoagulation period
- Cancer patients with DVT who have recurrent PE on anticoagulation or cannot tolerate anticoagulation
Is IVC Filter Placement Right for You?
An IVC filter is appropriate when:
- DVT or PE has been confirmed by Doppler ultrasound, CT pulmonary angiography, or venography
- Anticoagulation cannot be started or continued due to documented bleeding risk or a specific contraindication
- The expected duration of anticoagulation contraindication is temporary (favouring retrievable filter) or permanent (favouring a permanent device)
- The IVC anatomy is suitable for filter placement (normal IVC diameter, no significant IVC thrombus)
- A haematologist or vascular specialist has reviewed and agreed on the indication for filter placement
Why IVC Filters Protect Life in High-Risk Patients?
Pulmonary embolism is a medical emergency with serious consequences:
- Massive PE (large clot blocking the main pulmonary artery) causes sudden cardiovascular collapse and carries a mortality rate of up to 30 to 60% without immediate treatment
- Patients who cannot take anticoagulants after DVT have a PE risk of 30 to 60% without a filter
- An IVC filter reduces the risk of clinical PE by trapping the majority of clinically significant clots before they reach the lungs
- Retrievable filters can be removed once the bleeding risk passes, reducing long-term complications
- For cancer patients and post-surgical patients with high clot burden, IVC filters provide critical short-term protection
IVC filters reduce the risk of pulmonary embolism by over 85% in patients with DVT who cannot receive anticoagulation.
At Shree Hospitals, our interventional radiology team places and retrieves IVC filters using precision fluoroscopic guidance, offering life-saving protection against pulmonary embolism for high-risk patients who cannot safely receive anticoagulant therapy.
24×7 Emergency Care
Our Approach to IVC Filter Placement
At Shree Hospitals, IVC filter placement is performed only when clearly indicated and in close collaboration with the referring haematology, surgical, or medical team. We use retrievable filters as the default choice in all patients where eventual retrieval is anticipated, and we proactively track all filter patients for timely retrieval once anticoagulation becomes safe.
24×7 Emergency Care
Multidisciplinary Indication Review
Every IVC filter request is reviewed by our interventional radiologist in discussion with the referring team to confirm the indication, bleeding risk, expected duration of anticoagulation contraindication, and choice of filter type. Duplex ultrasound confirms the presence and extent of DVT. CT of the IVC or cavography assesses IVC diameter (suprarenal filter if IVC is dilated beyond 28mm) and excludes IVC thrombus that could complicate filter placement or increase thrombotic risk.
Precision Filter Deployment
IVC filter placement is performed under fluoroscopic guidance via internal jugular vein access (most commonly) or femoral vein access. A cavogram (contrast injection mapping the IVC) is performed to identify the renal vein ostia, confirm IVC diameter, and detect any anatomical variants or existing thrombus. The filter is deployed precisely in the infrarenal IVC just below the lowest renal vein using the delivery system. Cone-beam CT confirms satisfactory filter position and expansion.
Filter Retrieval Programme
Shree Hospitals operates a structured IVC filter retrieval programme to ensure that all patients with retrievable filters are reviewed at regular intervals and offered filter removal as soon as anticoagulation can be safely started. Filters that are left in permanently accumulate complications over time including IVC thrombosis, filter fracture, and filter migration. Our team performs filter retrieval using standard and advanced endovascular snare techniques and can retrieve filters that have been in place for extended periods.
Anticoagulation Transition and Long-Term Management
After IVC filter placement, our team works with the haematology and vascular team to plan timely transition to anticoagulation once the bleeding risk resolves. Anticoagulation must be started as soon as it is safe to do so - the filter provides physical protection but does not treat the underlying DVT or reduce its extension. Filter retrieval is scheduled once a safe course of anticoagulation has been completed. Patients with permanent filters require long-term anticoagulation where possible and regular imaging follow-up.
Top Interventional Radiologists and Vascular Specialists in Mumbai
Every specialist at Shree Hospitals is board-certified and has an average of 15+ years of clinical experience in IVC filter placement and retrieval, venous interventions, DVT management, and vascular interventional radiology.
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10+ years of experience
Dr. Swati Narurkar
Interventional Radiology
Interventional Radiology Services at Shree Hospitals
We offer a comprehensive range of minimally invasive interventional radiology procedures including IVC filter placement, peripheral angioplasty and stenting, vertebroplasty, UAE, radiofrequency ablation, TACE, percutaneous drainage, and biliary drainage, all delivered by specialist interventional radiologists.
Step by Step Process of IVC Filter Placement
Step 1 - Clinical Assessment and Indication Confirmation
The interventional radiologist reviews the referral, confirms DVT or PE is documented on imaging, identifies the contraindication to anticoagulation, and determines the expected duration of that contraindication. The choice of retrievable vs permanent filter is decided. Duplex ultrasound of the deep veins and CT of the IVC are reviewed. The procedure, risks, and planned retrieval strategy are discussed with the patient and consent is obtained.
Step 2 - Patient Preparation
Blood tests including clotting profile, full blood count, and renal function (contrast will be used) are checked. The access site (neck or groin) is prepared with antiseptic. Local anaesthetic is drawn up. Intravenous access is established for medications. Intravenous fluids are given for renal protection. The patient is positioned supine on the fluoroscopy table.
Step 3 - Venous Access
Under ultrasound guidance, the right internal jugular vein in the neck is punctured with a needle and a sheath is inserted. The jugular approach is preferred as it avoids passage through the thrombus in the iliac or femoral veins. Alternatively, femoral vein access is used if jugular access is not possible or the thrombus is limited to the popliteal veins. The sheath is flushed with heparinised saline.
Step 4 - Cavography and Filter Deployment
A flush catheter is advanced under fluoroscopy to the level of the renal veins. Contrast is injected to perform a cavogram - an X-ray map of the IVC - identifying the renal vein ostia (the lowest point above which the filter must not be placed), measuring IVC diameter, and detecting any existing IVC thrombus. The filter delivery system is advanced to the infrarenal IVC and the filter is deployed precisely below the renal veins under fluoroscopic guidance. Cone-beam CT confirms the filter is correctly positioned and fully expanded against the IVC wall.
Step 5 - Completion and Access Site Management
The delivery sheath is removed and the access site is compressed manually or closed with a suture. The patient rests for 30 to 60 minutes for monitoring. The post-procedural position and expansion of the filter are confirmed on a plain abdominal X-ray. Antibiotic prophylaxis is not routinely required. Most patients ambulate within hours.
Step 6 - Discharge and Filter Retrieval Planning
Most patients are discharged the following day. The IVC filter retrieval date is discussed before discharge and a reminder system is established to ensure the patient returns for retrieval when anticoagulation can be safely started. Anticoagulation is initiated as soon as the bleeding risk resolves. Filter retrieval is planned once a full therapeutic course of anticoagulation has been completed (typically 3 to 6 months). Retrieval is performed as a day-case procedure using a snare catheter introduced via the jugular vein.
Patient Questions About IVC Filter Placement
Can I feel the IVC filter after it is placed?
No. IVC filters are positioned deep within the inferior vena cava in the abdomen and patients cannot feel them after placement. The procedure itself is performed under local anaesthesia and most patients feel only mild discomfort at the needle puncture site in the neck or groin during the procedure. After discharge, the IVC filter is completely asymptomatic in the vast majority of patients. It does not affect normal activities, and modern filters are compatible with MRI scanning.
Does an IVC filter treat the blood clot in my leg?
No. An IVC filter prevents clots from the legs and pelvis from reaching the lungs - it does not dissolve or treat the existing DVT in the leg veins. The DVT itself still needs to be treated with anticoagulation as soon as it is safe to do so. Without anticoagulation, the existing leg clot may extend, causing progressive venous damage, post-thrombotic syndrome (chronic leg swelling and pain), and increased risk of new clot formation. The filter is a temporary protective measure while anticoagulation is contraindicated - not a replacement for blood-thinning treatment.
How and when is the IVC filter removed?
Retrievable IVC filters are removed via a percutaneous endovascular procedure through the jugular vein using a snare catheter to grasp the filter hook and collapse it for withdrawal through a sheath. This is a straightforward procedure done under local anaesthesia as a day case. Filters should ideally be retrieved within 3 to 6 months of placement as retrieval becomes more complex the longer a filter remains in situ. Our filter retrieval programme tracks all patients and schedules retrieval proactively. Advanced retrieval techniques allow removal of even long-dwelling filters that have partially embedded in the IVC wall.
What are the risks of leaving an IVC filter in permanently?
Permanent IVC filters carry long-term risks that increase over time, including IVC thrombosis (clotting of the IVC around the filter, causing severe leg swelling), filter fracture (strut breakage with rare migration of filter fragments), filter migration (movement of the filter from its original position), and IVC penetration (filter struts eroding through the IVC wall into adjacent structures). For these reasons, retrievable filters are preferred over permanent ones wherever possible, and retrieval should be performed as soon as anticoagulation becomes safe. Long-term anticoagulation is recommended for all patients with permanent filters to reduce IVC thrombosis risk.
Evidence-Based Case Studies
Would Recommend Us
"I had a large blood clot in my leg after surgery and my surgeon said I could not take blood thinners so soon after the operation. The interventional radiology team placed an IVC filter the same day to protect me. I recovered from my surgery safely and the filter was removed three months later."
Mr. Pradeep S
"My cancer treatment was complicated by blood clots that kept recurring even on blood thinners, and I had bleeding from my gut making anticoagulation dangerous. The IVC filter at Shree Hospitals protected me while my bleeding was treated. It was a critical procedure at a very difficult time."
Mrs. Rekha T
"After my accident I had clots in both legs but a head injury meant blood thinners were too dangerous. The team at Shree Hospitals placed an IVC filter urgently. I completed my rehabilitation safely and the filter was retrieved once I could start anticoagulation."
Mr. Arun D
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