Discover the Types of Vena Cava Filters: A Comprehensive Guide for Healthcare Professionals

Vena cava filters may prevent blood clots in your veins from reaching your lungs. They may be permanent, long-term solutions or temporary screens that may be removed after a few weeks or months.

The vena cava is the large vein that carries blood back to your heart from the rest of your body. If a blood clot forms in a vein (venous thromboembolism, or VTE), your doctor may recommend the placement of an umbrella-shaped metal filter in your vena cava to prevent the clot from traveling to your lungs.

There are multiple types of vena cava filters that doctors may use.

A clot that blocks blood flow in one of your lungs’ arteries is a potentially life threatening condition called a pulmonary embolism (PE).

The vena cava has two distinct sections. The superior vena cava (SVC) delivers blood from your head, chest, and arms to your heart. The inferior vena cava (IVC) brings blood to your heart from your feet, legs, and abdominal and pelvic organs.

Filters are most commonly implanted in the IVC. Depending on the size and location of the clot, vena cava filters may be permanent or retrievable. This article explains more about vena cava filter types and the criteria doctors use to decide which type will be the safest and most effective protection against PE.

Are there different kinds of vena cava filters?

The two main types of vena cava filters are permanent (meant to be in place for the long term) and retrievable (able to be removed once the threat of a PE has passed).

Permanent vena cava filters

As the name implies, a permanent vena cava filter is meant to stay in place for life. Permanent vena cava filters are not designed for easy removal, though some can be taken out without major complications.

A doctor will usually recommend a permanent filter if you cannot take anticoagulant medications (also known as blood thinners), which help slow down the blood-clotting process.

A 2021 research review comparing permanent IVC filters with other non-filter treatments suggests that the use of a permanent filter decreased the risk of new PE without an increase in bleeding problems or new deep VTE formation.

The longer a filter is in place, the greater the risk is that the device will fracture or migrating toward your heart and lungs, thereby increasing the risk of a blood clot also reaching your lungs. One 2016 review found that device migration occurred twice as often with permanent filters as with retrievable filters.

Retrievable vena cava filters

Retrievable vena cava filters are meant for short-term use, but they are also approved for permanent use. If you can take anticoagulants and you have a temporary risk of VTE or PE, you may be a good candidate for a retrievable vena cava filter. A 2022 review also notes that a life expectancy of at least 6 months is one of the criteria for a retrievable filter.

Complications are more common with retrievable vena cava filters than with permanent filters. Device fractures are among the most frequent problems.

One explanation is that retrievable filters are often left in place longer than they are designed for, given that most retrievable filters should be removed within 30 days of placement. Some research cited in a 2016 review suggests that up to 33% of retrievable vena cava filters wind up staying in place permanently.

Is there an alternative to vena cava filters?

Not all blood clots in the vena cava require a filter. For some people, placement of a filter may not be safe. But there are other treatment options, including those described below.

Medications

The most commonly prescribed medications for deep vein thrombosis are anticoagulants. These include injectable anticoagulants, such as heparin, and oral anticoagulants, such as warfarin.

Other medications used to treat VTE are called thrombolytics, or “clot busters,” because they work by helping to dissolve blood clots. Both thrombolytics and anticoagulants raise the risk of bleeding complications, so their use must be closely monitored.

Thrombectomy

Depending on the size and location of the clot, it may be possible to destroy the clot before it becomes life threatening. A thrombectomy is a surgical procedure in which a surgeon inserts a special device into a blood vessel to remove the clot.

What are the risks of a vena cava filter?

As with any procedure or treatment involving your blood vessels, vena cava filters come with some risks.

Placing a filter in your vena cava involves inserting a catheter carrying the filter into an artery and then guiding it to the appropriate place in your vein. Once there, the filter is meant to stay in place, allowing blood to flow freely through it but blocking any clots that reach it.

Common risks of a vena cava filter include:

• bleeding complications
• damage to the vena cava caused by the filter itself
• infection
• injury to the artery at the incision site
• movement of the filter through the vein to the heart or lungs

Additionally, a vena cava filter may not capture a clot heading toward your heart and lungs, although this is unusual. Vena cava filters are generally safe and effective. A 2023 study suggests that the use of IVC filters is associated with significantly reduced risks of PE and other severe complications.

Q: What are the different types of vena cava filters?

A: The two main types are permanent vena cava filters, meant to be left in place long-term, and retrievable vena cava filters, designed for temporary use with the ability to be removed later.

Q: When would a permanent vena cava filter be recommended?

A: A permanent filter may be recommended if you cannot take blood thinning medications (anticoagulants) to prevent blood clots.

Q: What are the advantages of a retrievable vena cava filter?

A: A retrievable filter allows temporary protection against pulmonary embolism (PE) if you have a short-term high risk. It can potentially be removed once the clot risk decreases.

Q: Are there alternatives to using vena cava filters?

A: Yes, alternatives include anticoagulant medications to prevent clots, clot-busting thrombolytic drugs, or a surgical thrombectomy procedure to remove a clot.

Q: What are some potential risks of vena cava filters?

A: Risks include bleeding, vena cava damage, infection, filter movement/migration, and failure to stop a clot from reaching the lungs.

Q: How does a doctor decide between a permanent or retrievable filter?

A: Factors include ability to take anticoagulants, risk period for clots, life expectancy of at least 6 months for retrievable filters, and patient preferences.

Q: Are vena cava filters generally safe and effective?

A: Yes, vena cava filters are considered generally safe and effective for preventing life-threatening pulmonary embolisms, though all treatment options carry some risks.

The bottom line

The decision to use a permanent or retrievable vena cava filter depends on several key factors, including your preferences. If you’ve received a diagnosis of a blood clot in your vena cava, be sure to discuss all your treatment options with your doctor, including the risks and benefits associated with each one.

While vena cava filters can be effective in preventing a PE, they are not without risks. If your doctor advises you to have one, be sure that you understand the recommendation and whether they are suggesting a permanent or retrievable filter.