To the Editor.—Interruption of the inferior vena cava (IVC) is an accepted treatment for venous thromboembolic disease when anticoagulation therapy fails or is contraindicated. Complete interruption of the IVC is recommended when there is evidence of a septic component or when microembolic episodes are suspected. In all other cases, partial interruption is usually preferred. Spencer and Quaddlebauer1 described a technique for plication of the IVC that consists of creating channels, 3 mm in diameter, following the longitudinal axis of the IVC, by placing longitudinal mattress sutures through the vein. To facilitate this technique, a new instrument has been devised (manufactured by E. Cottely, Buenos Aires). Use of this instrument avoids both extensive dissection sometimes necessary for applying occlusive clamps and occlusive clamping itself, and ensures picking up the posterior wall of the vena cava during the application of the sutures.
The instrument consists essentially of two arms, as