抄録
The incidence of pulmonary embolism is recently increasing in Japan. Pulmonary embolism occurs mainly on the basis of deep vein thrombosis, and these conditions could be considered as the continuum of venous thromboembolism. Venous thromboembolism is traditionally considered to be relatively rare in Japan, as there are no specific congenital thrombophilia such as factor V Leiden. A recent increase in venous thromboembolism seems to attribute to the acquired thrombotic tendency in relation to the transition of the life style. Clinically, early and accurate diagnosis is critically important because of the high mortality rate from pulmonary embolism and the large number of cases not diagnosed before causing death. Over the last decade, diagnostic and therapeutic strategies have been changed. The integrated strategies based on clinical risk evaluation, D-dimer, and multi-row detector computed tomography scans result in safer, more convenient and cost-effective diagnosis with high sensitivity and specificity. As well as antigocagulation using heparin, interventions such as thrombolysis and placement of inferior vena cava filter are reserved for special situations. Early detection of deep vein thrombosis and thromboprophylaxis using low-molecular-weight heparin or pentasaccharide (fondaparinux), factor Xa inhibitor in high-risk patients would achieve more effective prevention of pulmonary embolism. [J Physiol Sci. 2008;58 Suppl:S40]
