Inferior vena cava filter placement

The inferior vena cava is the large vein that returns blood from the legs and abdomen to the heart. When a clot forms in the leg veins (deep vein thrombosis), it can break off and travel to the lungs: this is a pulmonary embolism. A vena cava filter is a small umbrella-shaped metal device placed in this vein to catch large clots. Placement is done in the catheterisation laboratory under local anaesthesia, through a puncture of a vein in the neck or groin. The filter is opened at the right level, just below the kidney veins, under X-ray guidance. The procedure is short and requires no incision. The standard treatment for deep vein thrombosis is anticoagulation. A filter is reserved for patients who cannot receive it (bleeding, urgent surgery) or in whom it has failed. Most filters used today are retrievable (optional) and should be removed as soon as anticoagulation is possible again, through a similar procedure. At Clinique Pasteur Tunis, filter placement and removal are performed in a latest-generation catheterisation laboratory, in coordination with the doctors treating the thrombosis.