Incidental Prophylactic Inferior Vena Cava Clipping

Eighty-eight high-risk patients underwent application of a partial occlusion, Teflon inferior vena cava clip as an incidental procedure during the course of laparotomy. No deaths occurred as a result of the clip and when compared to a control group of similar patients, no increase in postoperative thrombotic complications was observed. Three patients (3.4%) had clinical evidence of small pulmonary emboli in spite of the clip as compared to a like number of large, life-endangering emboli requiring vena cava interruption in the control series. Prophylactic inferior vena cava clipping performed as an incidental procedure during laparotomy on high risk patients appears to be a safe procedure which does not significantly increase postoperative complications, morbidity, or mortality and should prevent the large lethal pulmonary embolus although smaller emboli, large enough to produce symptoms, may pass through.