[Diagnosis of perioperative venous thromboembolism]

The points for diagnosis of perioperative pulmonary thromboembolism (PTE) are as follows. In the preoperative period, we need to make an effort to find the deep vein thrombosis, which can cause PTE. In the postoperative period, it is important to diagnose the PTE promptly, to judge its severity, and to decide the treatment plan. Since 2004 when the guideline for treatment for perioperative PTE was established, the morbidity rate of perioperative PTE in Japan has decreased. However, the mortality rate has not changed. There are few medical staffs with an experience of PTE because perioperative PTE rarely happens. In addition, the symptoms of PTE are not specific. Therefore, all procedures from the initial diagnosis to the final treatment should be made easy to understand. Moreover, to save the patients from preoperative PTE, it is necessary to start intensive care as soon as possible with cooperation of specialists including cardiologists, cardiac surgeons, ER staffs, etc. in each institution.