Series of Monographs on Venous Thromboembolic Disease
On behalf of the Society for Vascular Medicine and Biology and the editors of Circulation, we are pleased to present this series of monographs on topics in venous thromboembolic disease. The objective of these supplements is to provide clinicians with a current review of the epidemiology, diagnosis, natural history, prevention, and treatment of deep venous thrombosis, and its principal complications, pulmonary embolism and chronic venous insufficiency. These disorders affect millions of people, especially those predisposed by serious illness, major surgery, intrinsic venous disease, or hypercoagulable states, and are responsible for considerable mortality and chronic disability.
As with most vascular diseases, responsibility for recognition and prevention of venous thromboembolism in patients at risk falls mainly to the primary care physician. Hence, these supplements have been written with the needs of the practitioner in mind, aiming to provide a comprehensive compendium of practical information based, whenever possible, on data from well-designed clinical trials, so that recommendations parallel widely accepted clinical practice guidelines. Areas of controversy are identified as such, and when there is no consensus about optimum management, pragmatic approaches are offered. We have selected as guest editor for each monograph a widely recognized specialist in the topic at hand, and have asked each editor to guide the selection of authors for the detailed clinical reviews. A board jointly selected by the Society for Vascular Medicine and Biology and the editors of Circulation has reviewed each manuscript.
The series begins with an issue devoted to the epidemiology, risk factors, and natural history of venous thromboembolic disease. Discussions of hypercoagulability and of criteria for identifying high-risk patient populations are aimed at clarifying these complex issues for the practicing clinician.
The second monograph is centered on diagnostic approaches to patients with venous thromboembolism. Detailed descriptions of duplex ultrasonography, contrast venography, d-dimer assays, and emerging diagnostic modalities, including computerized tomographic angiography for diagnosis of pulmonary embolism, are provided, along with diagnostic algorithms.
Additional issues review alternative strategies for prevention and management of venous thromboembolic disease. Although effective prophylaxis against venous thromboembolism is available in the form of a variety of antithrombotic agents, these drugs are associated with risks of bleeding, making their judicious use dependent on appropriate assessment of patient-specific thromboembolic risk. When preventive strategies have been overlooked or fail, the problem of venous thromboembolism itself similarly requires a risk-based therapeutic approach. Hence, a comprehensive review of therapeutic alternatives completes the series. Comparisons of low-molecular-weight heparins with unfractionated heparin, the use of oral vitamin K antagonists, and emerging opportunities, like direct thrombin inhibitors and synthetic pentasaccharides, round out the analysis of current algorithms.
We hope this series of monographs provides a comprehensive resource, for primary care physicians and specialists alike, about current strategies in the diagnosis and management of this common and debilitating disease, and helps to foster improved patient care.