Long-term management of venous thromboembolism.

Deep vein thrombosis (DVT) is not a rare disease. General incidence of DVT is 0.2% of urban population per 1 year. It is very rare in the population of younger than 15 years-old. Older persons have higher incidence of DVT, 1.8 event will occur 1,000 person-year in 65 ~ 69 years-old, and 3.1 on 85 ~ 89 years-old people. One of important complication of DVT, especially in proximal (iliofemoral) DVT is the postthrombotic syndrome (PTS). The incidence of PTS after proximal DVT was 35~70% at 3years in old medical literature. Even in well-designed randomized clinical trials composed with adequate anticoagulation, early mobilization and long-term elastic compression, the incidence of severe grade PTS in proximal DVT is 4~8%. 1 year cumulative risk of PTS is 31% in women, and 15% in men with proximal DVT. Main purposes of proximal DVT are reduction of hemodynamic instability of DVT, and long term follow up plan to reduce incidence of PTS. Recently, there are many of attentions to facilitate acute management for proximal DVT with catheter directed thrombolysis, percutaneous transluminal angioplasty, and anticoagulation, but establishing long-term management plan, imaging and clinical follow up schedule are neglected.