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[New challenges in the management of patients with venous thromboembolism].

Venous thromboembolism encompasses deep venous thrombosis (DVT) and pulmonary embolism (PE), which represent different manifestations of the same disease process. Recent epidemiological studies confirm that DVT is a major health problem and that survival after pulmonary embolism is much worse than previously thought. Our understanding of the risk factors and natural history of DVT has undergone considerable evolution in recent years, influencing the clinical management of this epidemic disease. Known risk factors for DVT have been focused on hospitalised patients so that they have about 100-fold higher risk of developing DVT compared with non hospitalised people. So it is crucial for every hospital to develop its own strategy for prevention, diagnosis, treatment and follow-up of patients with DVT. It is now recognised that DVT is a chronic disease, given the high percentage of recurrences after the initial event. The possible modality to decrease the morbidity and mortality following DVT are: a) To develop prevention modalities that have been demonstrated efficacious by clinical evidence; b) To improve the diagnosis of DVT, emphasizing the crucial role of clinical suspicion in patients at high risk; c) To optimize the therapeutic management and follow-up of this chronic disease, with clinical and instrumental tools for monitoring patients during the follow-up and early recognizing the those at risk of recurrences and/or complications.