Bedside Insertion of the Inferior Vena Cava Filter in the Intensive Care Unit

Abstract

Historically, inferior vena cava (IVC) filters have been inserted in the Radiology Department or the Operating Room. When initially designed, vena cava filters required surgical cut down of the internal jugular vein to insert a large (24 French) introducer and it was therefore necessary to perform this procedure in the operating room. Percutaneous methods (e.g., the Seldinger technique) with smaller profile sheath-dilator devices (6 to 12 French) have made IVC filter insertion a much easier procedure. Furthermore, the remaining equipment is simple, portable, and readily available throughout most hospitals (e.g., C-arm, contrast, sterile drapes, gowns, gloves, catheters, etc.). These factors have made it easy to “bring the procedure to the patient.” This is particularly advantageous in critically ill ICU patients. Complication rates of “road trips” for critically ill patients from the ICU to other parts of the hospital (i.e., radiology department or operating room) can result in a mishap rate of 5–30. Secondary benefits of bedside insertion of vena cava filters include cost-effectiveness.