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How risky is removal of the IVC filter when the IJV is clotted?

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Posted on Tue, 26 Jul 2016
Question: I just had a 5 level neck fusion with instrumentation Rod's plate screws excetera had an IVC filter placed because of Prior pulmonary embolus now it's time to remove the IVC filter due to the blood clots I have in my IJV and the sub clavicle area of the ijv the Interventional radiologist suggest I leave the filter in for ever and said it's too risky to a plate and back in the class I want them all removed any suggestions currently on Xarelto 20 milligrams
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Answered by Dr. Ilir Sharka (54 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!
I carefully passed through your question and would agree with your radiologists advice to hold these filters forever.

I would explain that these filters offer to you a more potent protection than xarelto, especially when there is a potential risk for recurrent thrombotic events.

So, using both filters and xarelto, you increase your protection from possible dangerous embolic events.

Hope to have been helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (36 minutes later)
what about the two large blood clots in the IJV and slightly lower in the sub clavicle IJV... they're very large and painful he said the walls of the vein that reside in are also very sick from inflammation he does not want to melt and vacuum them out however I am afraid they will travel this clot or blocked the flow of blood going to my brain he does not want to remove them stating the possibility of complications and pieces going to the heart and lungs my last PE took over a year to resolve itself I do not want to feel like there is a frying pan that has been heated up on my back for a year until they dissipate please help
doctor
Answered by Dr. Ilir Sharka (17 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would explain that anticoagulation therapy and filters are used for your protection from possible embolic events.

You should not worry about that!

From the other hand blood clots in the venous system are treated differently from the arterial systems (which are treated with surgery or endovascular procedures). They tend to recreate. Anticoagulation therapy not only prevents this, but also helps regulate the blood balances in order to destroy the present blood clots. For this purpose a period of some months is needed.

The only thing, I would try to explore is the cause of all these blood clots. Have you performed any coagulation tests? What about inflammation or a systemic disorder like antiphospholipid antibody syndrome, lupus, etc..?

Have you ever performed any tests to exclude these possibilities?

You should know that it is quite abnormal at your age to have recurrent blood clots in your veins. Further investigations should be done to find the possible causes:

-coagulation tests
-PCR, sedimentation rate
-ANA, XXXXXXX
-ENA
-antiphospholipid antibodies
-anticardiolipine antibodies, etc.

You should discuss with your doctor on the above issues.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 4714 Questions

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How risky is removal of the IVC filter when the IJV is clotted?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I carefully passed through your question and would agree with your radiologists advice to hold these filters forever. I would explain that these filters offer to you a more potent protection than xarelto, especially when there is a potential risk for recurrent thrombotic events. So, using both filters and xarelto, you increase your protection from possible dangerous embolic events. Hope to have been helpful! Kind regards, Dr. Iliri