Equipment

Equipment used in placing an inferior vena cava (IVC) filter includes the following:

Ultrasound machine with linear-array probe
Fluoroscopy
Chlorhexidine or povidone-iodine solution for skin disinfection
Heparinized saline (1000 IU heparin in 1000 mL of 0.9% saline)
Basic angiography set
Catheter (a catheter with radiopaque calibration markers can be helpful to measure caval diameter)
Guide wire, 0.035 in.
Filter kit (this article describes the insertion of a Cook Gunther Tulip or Celect potentially retrievable filter via jugular or femoral approaches)

Anesthesia

Local anesthesia with approximately 5 mL of 1% lidocaine may be administered via infiltration before venipuncture. (See Local Anesthetic Agents, Infiltrative Administration.) Procedural sedation is optional and may be considered, depending on the patient and on local practices.

Positioning

The patient should be supine. When using the jugular approach, some operators have the patient rotate his or her head in a contralateral direction.

Technique

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Media Gallery

Transverse neck ultrasonography shows anatomic relation of internal jugular (IJ) vein and carotid artery. Note that vein is compressible.
Ultrasound-guided puncture of right internal jugular (IJ) vein.
Inferior vena cava (IVC) filter placement. IVC thrombus and suprarenal filter.
Inferior vena cava (IVC) filter placement. Ultrasound-guided puncture of right internal jugular (IJ) vein.
Inferior vena cava (IVC) filter placement. Cavogram after filter deployment.
Inferior vena cava (IVC) filter placement. Cavogram after filter deployment.
Inferior vena cava (IVC) filter placement. Shown is 7 French sheath with filter inside.
Inferior vena cava (IVC) filter placement. Filter unsheathed but still hooked on.
Inferior vena cava (IVC) filter placement. Filter fully released.