A pulmonary embolism is a blockage of one or more arteries in the lungs. It is most often caused by a blood clot that travels to the lungs from another part of the body. Blood clots usually form in the veins of the legs or arms, but can dislodge and travel through the bloodstream to the lungs. A pulmonary embolism is a complication of deep vein thrombosis, and can be life-threatening.
What Causes Pulmonary Embolism?
Pulmonary embolism can affect anyone, but certain factors, including the following, increase the risk of developing one:
- Physical inactivity
- Prolonged bed rest or travel
- Family history of blood-clotting disorders
- History of cancer or chemotherapy treatment
- Trauma or injury to a vein
- Oral contraceptive use
- Using hormone-replacement therapy
What Are The Symptoms Of Pulmonary Embolism?
Symptoms of pulmonary embolism vary depending on the severity of the blockage, but include the following:
- Sudden shortness of breath
- Sharp pain in the chest, arm, shoulder, neck or jaw
- Clammy skin
- Rapid heartbeat
- Excessive sweating
- Swelling in one of the legs
How Is Pulmonary Embolism Diagnosed?
A pulmonary embolism is difficult to diagnose, although it may be detected with the following:
- Chest X-ray
- CT scan
- Lung scan
- Blood tests
- Pulmonary angiogram
How Is Pulmonary Embolism Treated?
Treatment for pulmonary embolism requires vital signs need to be closely monitored. The clot’s severity and the patient’s medical condition determine the physician’s recommendation. Treatment for pulmonary embolism typically includes anticoagulant (blood-thinning) medication; thrombolytic therapy; and surgical placement of an inferior vena cava filter.
Can Pulmonary Embolism Be Prevented?
Maintaining an appropriate level of physical activity, drinking plenty of fluids, and wearing compression stockings to keep circulation flowing in the legs help prevent pulmonary embolism.
IVC Filter Placement
An inferior vena cava (IVC) filter is a vascular filter that is inserted through a small incision into the main vein in the abdomen. This vein in the abdomen is called the inferior vena cava. The filter prevents blood clots from breaking loose in leg veins and lodging in the lung. The IVC filter is typically implanted permanently in those patients with a high risk of pulmonary embolism.
What Happens During an Inferior Vena Cava Filter Placement?
The procedure to place an inferior vena cava filter takes about an hour. It's performed using IV sedation, which can make you very relaxed during your procedure. You may enter a light sleep state and will be free of pain. If needed, the nursing staff may shave the area in the neck or groin where the catheter will be inserted. The skin will be cleaned and you may also receive a local anesthetic to numb the tissue around where the catheter will go. The doctor will insert a thin catheter through the incision and into a vein that leads to the inferior vena cava. The catheter will be progressed to the inferior vena cava using x-ray imaging with contrast dye. When the catheter reaches the intended position, the filter is released. There, the filter will expand and adhere to the walls of the large vein after the catheter is removed. To complete the procedure, the doctor will close and bandage the incision.
What Should I Expect After the Inferior Vena Cava Filter Procedure?
Your filter insertion may be performed as an outpatient procedure. When the surgery is complete, you'll be moved to a monitored recovery room. When you wake up, you may feel confused and groggy as a result of the sedation you received during surgery. This medication and the contrast material may also cause you to feel nauseous or may give you a headache. These side effects tend to go away very quickly. If needed, you may receive pain medication while in the recovery room. The staff will also monitor your breathing, heart rate, and other vital signs until the effects of your sedative have worn off. When you're alert, you'll be released to a friend or loved one whom you've arranged to pick you up and drive you home. You should not drive until the day following your treatment.
The recovery from inferior vena cava filter placement isn't long. However, you may feel some discomfort for which you'll want to take pain medication. You may also have some bruising at the site where the catheter was inserted. It's ideal to take it easy for the remainder of the day. You should strictly avoid strenuous activities for a day or two, and, when you resume your normal activity level, take it slow and pay attention to how you feel.
This treatment is considered a safe, effective method of preventing blood clots from getting to the lungs. That said, there are some risks involved. Contact the office if you experience any of the following:
- Persistent bleeding at the incision site.
- Fluid leaking from the incision site.
- Pain, warmth, redness, or swelling at the incision site.
- Persistent nausea or headache.
- Chest pain.
It is important that you follow your doctor's aftercare instructions following inferior vena cava filter insertion. You may need to take blood-thinning medication short or long-term and may be scheduled for follow-up imaging to confirm the correct location of your filter. Follow-up care will be discussed around the time of your procedure so you can plan accordingly.