ABSTRACT
This chapter includes guidelines from an Australian and New Zealand working party on the management and prevention of venous thrombo-embolism (VTE) and an international consensus statement. Treatment for VTE aims to reduce symptoms from superficial vein thrombosis and deep vein thrombosis, avoid the risk of death from pulmonary embolism (PE), and attempt to avoid or restrict the postthrombotic syndrome. Open surgical thrombectomy has been largely replaced by endovenous techniques, but is occasionally required for patients with massive swelling and phlegmasia cerulea dolens where there is a contraindication to fibrinolysis or if it is considered that the clot is too extensive to be dealt with by endovascular techniques. Clearance of thrombus frequently discloses an underlying venous stenosis that can be readily controlled by balloon dilatation with intravascular stents. The goals are to reduce the severity and duration of lower limb symptoms, prevent PE, diminish the risk of recurrent venous thrombosis and limit or prevent venous valve damage and the post-thrombotic syndrome.
