Introduction-Uncharted Territories in Thrombosis Care: Expanding into New Areas

The low-molecular-weight heparins (LMWHs) have had a tremendous impact on clinical practice. Since the original description of their first clinical evaluation for the prevention of postoperative deep-vein thrombosis by Kakkar and colleagues in 1982, some 400 clinical studies have established their use in a variety of clinical indications. These data from clinical trials are supplemented by a unique ``real-life'' experience of their safety and efficacy in some 100 million patients. LMWHs are now the first-line antithrombotic agent for the prevention and treatment of venous thromboembolic diseases and for the management of acute thrombotic coronary syndromes. Furthermore, their well-proven safety, established to be widely applicable in a variety of patient populations, including the elderly and those considered at greater risk for bleeding complications without the need for routine monitoring, will mean that LMWHs remain the antithrombotic agent of choice for the vast majority of patients.

During the XVIIIth Congress of the International Society on Thrombosis and Haemostasis, we had the pleasure of organizing a satellite symposium entitled ``Uncharted Territories in Thrombosis Care: Expanding into New Areas,'' which was supported by an unrestricted educational grant from Aventis Pharma. The objectives of the meeting were to identify the expanding horizons for thrombosis care in high-risk patient populations. A distinguished faculty presented the current state of the art for the use of LMWH in venous and arterial thrombosis, identified unmet clinical needs, and presented exciting new data on the novel indications for and ever-increasing utility of LMWHs. Updated references have been included in some of the articles to take into account important data published in the months following the meeting, and we hope that the reader will find each article a valuable source of information. It gives us great pleasure to present the proceedings of this symposium, which define the expanding role for LMWHs and update our knowledge of their use in clinical practice.