2010 Volume 30 Issue 7 Pages 987-995
Recently in Japan, venous thromboembolism (VT) [deep vein thrombosis (DVT)/pulmonary thromboembolism (PTE)] has increased with the Westernization of eating habits and the aging of society. In the West, prophylactic guidelines have been discussed for many years, and, unfortunately, Japan falls far behind the West in this area. Therefore, the necessity of thromboprophylaxis in the Japanese population should be emphasized based on reliable VTE studies in Japan. We developed Japanese Guidelines for VTE prophylaxis based on the 6th ACCP guidelines in 2004. The incidence of perioperative PTE in Japan has been investigated by the Japanese Society of Anesthesiologists since 2002. The rate of perioperative PTE was estimated to be 4.76 per 10,000 operations in 2003. As we expected, it decreased to 3.61 immediately after the guidelines for thromboprophylaxis were issued and the management fee for PTE prophylaxis was covered by health insurance in April 2004. Furthermore, it decreased by half in 2006. However, mechanical prophylaxis alone is not sufficient to prevent PTE, and advanced prophylaxis using anticoagulants, such as low-molecular-weight heparin/selective Xa inhibitor along with unfractionated heparin (UFH)/vitamin K antagonists (VKA) will be essential. The advanced revised guidelines for VTE prophylaxis based on our clinical evidence will be established in the near future.
