Fifty-one consecutive cases of inferior vena caval interruption for documented pulmonary embolism are reported. Forty-four patients underwent transabdominal vena caval clipping using the multichannel Adams-DeWeese clip, and seven critically ill patients were treated with vena caval umbrella. Operative mortality was 4 per cent. Only one patient developed edema attributable to clipping whereas postinterruption stasis sequelae were common after umbrella insertion. Vena cavography at six months and eight years demonstrated 85 per cent patency in the clip group and 16 per cent in the umbrella group.