Pulmonary Embolism and Inferior Vena Cava Filter

What is a pulmonary embolism?

Pulmonary embolism (PE) is a blockage of the pulmonary (lung) artery or one of its branches by a thrombus (blood clot), which detached and has traveled from another site via the venous circulation causing an obstruction known as an embolism.

Where does the clot originate?

Thrombus (blood clot) usually originates from the deep leg veins or pelvic area including Deep Vein Thrombosis.

What are the symptoms?

Symptoms are often non-specific and can mimic other pathological conditions:

  • chest pain on inspiration,
  • difficulty breathing and palpitations,
  • coughing up the blood (hemoptysis).

Is a pulmonary embolism serious?

Yes. Pulmonary embolism is a serious complication and needs to be treated urgently. The first line of treatment is with anticoagulants (heparin and warfarin) and catheter guided thrombolysis of the clot when indicated.

What other treatments are available?

An Inferior Vena Cava filter can be placed where a patient is at risk of a PE due to known Deep Vein Thrombosis.

What is an Inferior Vena Cava Filter?

An Inferior Vena Cava Filter (IVC Filter) is a type of vascular filter used to prevent PE by catching the emboli before it reaches the heart.

Who would an IVC filter be needed?

In patients with diagnosed deep vein thrombosis part of the thrombus can detach and travel from the affected vein toward the heart causing pulmonary embolism.

When is an IVC filter used?

An IVC filter is used when there is a contraindication for anticoagulant therapy (cerebral haemorrhage) or if the anticoagulation treatment proved to be ineffective.

How is an IVC filter placed?

An IVC filter is catheter-guided and implanted in the inferior vena cava below the renal veins. IVC filter reduces the risk of acute or subacute thromboembolitic complications, and can be placed on a temporary or permanent basis depending on the patient.

Learn more about Inferior Vena Cava Filters from Inside Radiology

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Author: Dr John Vrazas MB,BS FRANZCR