All patients with proven deep vein thrombosis are treated with heparin for days and sometimes weeks followed by oral anticoagulants. The goals of therapy are to prevent pulmonary embolism, restore venous patency and valvular function in veins, and to prevent postphlebitic syndrome. For the past 40 years or more intravenous heparin has been the standard therapy used for several days before commencing oral anticoagulation with warfarin. During the past few years, however, clinical trials have shown that low molecular weight heparin (LMWH) given subcuta-neously provides the same protection as intravenous heparin. Most important, these agents can be used in the home avoiding expensive hospitalization.
3. Venography
Venography is the investigation of choice for patients with indeterminate diagnosis from ultrasound, D-dimer, and the probability from clinical assessment by a physician. An algorithm for the diagnosis of the deep vein thrombosis is given in Fig. 1. Not all scenarios are covered by algorithms, however.
B. Prophylaxis
The prevention of deep vein thrombosis in patients undergoing hip and knee surgery is vital. These patients should be treated with LMWH, such as enoxaparin admin¬istered approximately 6 h after surgery and continued for 2–3 weeks. In Europe LMWH is often administered

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