Anyone else need vascular filters before surgery?

[MommaZ 32]

I have an appointment with the vascular surgeon tomorrow... was wondering if anyone else has had/will have filters placed before surgery?

[heidikat72 935]

My surgeon's practice has installation of IVC filter prior to surgery as part of their protocol for high BMI (over 60) patients. In theory, if you develop a blood clot in your leg and it starts to move, the filter will catch it before it reaches your lung leading to a potentially deadly pulmonary emobolism. It is a relatively simple procedure (outpatient and usually in the vascular doc's office) to install and then it gets removed 4-6 weeks after surgery. There are risks associated with them though that you should ask about - the filters themselves can migrate, penetrate the vessel wall, induce formation of a clot around the filter etc - which can then make removal of the filter impossible.

I questioned the need for it and did my own research (totally my personal decision, I question everything and work in pharma so was able to look up some research on them). I ended up meeting with the vascular surgeon as well as a hematologist. The hematologist and I went through my full medical history and family history to determine an overall risk level for blood clots. Ultimately we decided that for me, the IVC filter really wasn't necessary as I didn't have any other clotting risk factors other than just getting the surgery and my surgeon was fine with that. So instead, I took lovenox (a blood thinner) injections twice a day for 14 days after I got home from surgery (i was given heparin injections in the hospital). The lovenox injections are just subcutaous (pinch a little skin on your love handle area and inject a really small needle - didn't really hurt, just a slight stinging sensation for a few minutes).

I would recommend to ask the vascular doc a lot of questions - how many does he do, rate of complications (and what type of complications), retrieval success, ask for data demonstrating benefit outweighs risk (whenever I asked about this I was told the data is inconclusive at this point). Then I would suggest meeting with a hematologist to go through your personal history to determine your risk of developing a clot.

Many people get the filters installed no problem so I'm not trying to scare you. I just think everyone should ask questions of their medical team and do their own research to get the data they need to make an informed decision that is right for them rather than just accepting a general practice protocol.

[MommaZ 32]

For me, it isn't really an option. Had my visit with the vascular surgeon today and he said my surgeon won't do my surgery without it - due to my history. I had a problem with a high number of PE's a few years ago while I was battling Leukemia. I was on Lovenox for almost a year, and will most likely go on it for awhile after surgery. Since the biggest risk of clots is in those who've had them before, and I had such a large amount of them, I'm very high risk. I'm actually a bit relieved, as clots are something I was really concerned about.

But your info is great! And you're so right - it's always best to question and not just go with the flow. I've never heard anyone say they researched an important matter too much!!

[heidikat72 935]

ok yeah if you've had PE's before, then it's a good idea. and they will likely still have you do the lovenox injections even with the IVC filter. and get up walking as soon as you can after surgery. I was annoying the nurses in the recovery area after my surgery because i was demanding to walk as soon as I woke up! haha they were glad when an actual room opened up for me to go to.