Our young patient with newly diagnosed DVT has cervical cancer and needs total abdominal hysterectomy semi-urgently.  As the DVT is recent and as the surgery has a high risk of blood loss it is felt that inserting an IVC filter will be necessary to help reduce the risk of PE due to disruptions in anticoagulation.  Unfractionated heparin is useful due to its short half life and relative easy of reversibility with protamine, however pragmatically it is often difficult to manage as most wards are inexperienced now.  LMWH is less easily reversed by protamine.

She is also given some intravenous iron to correct the iron deficiency, which may reduce the need for blood transfusion.

Questions

• What are the risks of an IVC filter?
• Do patients require ongoing anticoagulation?
• When should it be removed?

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