Pulmonary artery thromboembolism (PE) is a most severe complication of inferior vena cava (IVC) thrombosis. The problem of its surgical prevention has been in the focus of attention for many decades. The literature contains conflicting data concerning indications for open and endovasal interventions on IVC, frequency of their postoperative complications, immediate and delayed outcomes. Thus far, there is no consensus as regards approaches to partial IVC occlusion. Many researchers acknowledge advantages of the method but insist on reasonable narrowing indications for its application. The working group of European Society of Cardiologists arrived at a similar conclusion in its recent recommendations. The majority of the authors agree on the necessity of large-scale comparative studies with a view to optimizing surgical strategies for the prevention of PE. Such studies would provide a basis for various open and intravascular interventions well-grounded in term of cost effectiveness.