Venous thromboembolism: Past, present and future

Over the last four decades there have been remarkable advances in the diagn osis and treatment of venous thromboembolism (VTE)-pulmonary embolism (PE) and deep venous thrombosis (DVT). We have moved from no objective documenta tion to a plethora of ever improving imaging studies. Evolving treatment mo dalities have reduced the mortality duc to PE to similar to2%. Shorter hosp italizations followed by outpatient therapy are a growing reality The use o f primary prophylaxis is increasing, but more widespread use must be encour aged. Despite the many accomplishments, too many patients with VTE with its high mortality without treatment remain undiagnosed. There is a critical n eed to improve the role of the patient's history in identifying patients wh o warrant objective testing. The ideal would be the development of a biolog ical marker of VTE, similar to the creatinine kinase-MB, creatinine kinase- MM, or troponin I in acute myocardial infarction.