Venous Thromboembolism PDF

PREFACE

The purpose of this volume is to present our current understanding of venous thromboembolism (VTE).We will review the evolution of our understanding of this disease since it was first described by Virchow nearly a century and a half ago.

Therapy for venous thromboembolism is effective, but it is of no value unless the diagnosis is suspected and confirmed. Unfortunately, the clinical diagnosis of VTE continues to lack sensitivity and specificity. Pulmonary embolismis confirmed in only one-third of the patients in whom it is clinically suspected. Clinical prediction models have been developed that increase the specificity of the clinical diagnosis of VTE, thereby avoiding unnecessary diagnostic testing. However, these clinical prediction models can be used only if the diagnosis of VTE is suspected. Unfortunately, the sensitivity of the clinical diagnosis of VTE continues to be very low. In patients who die of pulmonary embolism, the diagnosis was suspected and treatment was initiated in only one-third of the patients.

Until the accuracy of the clinical recognition of VTE is greatly improved, improved therapy will not have a major impact on the number of patients dying of pulmonary embolism.

Our ability to identify patients at risk of VTE because of recently recognized hypercoagulable conditions and/or acquired risk factors continues to improve. This, along with the availability of new and more effective anticoagulants will have a major impact on preventing VTE and its fatal complication of pulmonary embolism.

It is the hope of the authors that this volume will increase the understanding of VTE, and thereby help to improve its prevention, diagnosis, and treatment.