Why aren’t more people after coronary bypass surgery given an SVC filter to prevent any blood clots from becoming a pulmonary embolism, since a DVT can suddenly break off and travel to the lungs?
Experience Hits Home
To this day I still wonder why my mother didn’t have an SVC filter placed after it was determined she had a “big DVT” in her neck after CABG.
The DVT was detected via ultrasound while she was still in ICU.
Nothing was done. I was told there was a “slim” chance of it dislodging and becoming a pulmonary embolus.
And that’s true: a DVT post-CABG is rare, and it’s even rarer that it will ever embolize.
A pulmonary embolus can cause sudden death.
A “saddle” type pulmonary embolism, plugging up the area where the pulmonary artery splits off into each lung. This can cause death in minutes. Laboratoires Servier, Wikimedia Commons
However, placement of an SVC filter (think of a fishing net in the superior vena cava blood vessel, trapping blood clots, preventing them from getting into the lungs) is non-invasive and a 20 minute procedure!
“If patient not be anticoagulated and it is contraindicated, an SVC filter can be an option,” says Paul Lucas, MD, a surgeon with the Vascular Center and director of the Vascular Laboratory at Mercy Hospital in Baltimore.
“Several studies have shown that it is a safe and viable option; it does however require very precise placement, as the SVC is a fairly short vessel as compared to the IVC [inferior vena cava].
Update on SVC Filter Use
As of 2026, use of these filters is still not standard.
The 2025 American Venous Forum guidelines say a temporary SVC filter may be considered only in highly selected patients who either have a high risk for a pulmonary embolism or have a strong contraindication to blood thinners.
There is no FDA-approved filter specifically designed for the SVC.
Doctors have instead used existing IVC filters in the superior vena cava, off-label.
Blood thinners are still the standard treatment for a DVT in the neck or elsewhere in the upper body.
Placement of a filter in the SVC carries risk of a new clot, perforation or cardiac arrhythmia.
Dr. Lucas leads a team of vascular surgeons and technologists who specialize in the diagnosis and treatment of patients with diseased blood vessels.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
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