Results: 1.Progression of thrombus length and volume (40% vs. 28%; P<.001) 2.Reduced pain with compression and ambulation (P<.001) 3.Reduced edema (P<.001) 4.No new PE on V/Q scan Results: 1.Progression of thrombus length and volume (40% vs. 28%; P<.001) 2.Reduced pain with compression and ambulation (P<.001) 3.Reduced edema (P<.001) 4.No new PE on V/Q scan Deep Vein Thrombosis Initial Treatment: Compression & Ambulation 1.Blattler W., et al Int’l Angiol. 2003; 32: Partsch H. et al J Vasc Surg 2000; 32: Blattler W., et al Int’l Angiol. 2003; 32: Partsch H. et al J Vasc Surg 2000; 32: 861-9

Acute DVT Duration of Anticoagulation Studies have shown… …the longer the better!

Anticoagulation for Acute DVT Duration of Warfarin: Randomized Trial Kearon C et al NEJM 1999;340;901. Kearon C et al NEJM 1999;340;901. Recurrent VTE 3 Mos 24.1 >1 Year 1.3 P-value <0.001 RRR 95% Endpoint (non-fatal)(non-fatal) Percent per Patient Year Major Bleed Study Interim Analysis

Long-Term Low-Intensity Warfarin Therapy for the Prevention of Recurrent Venous Thromboembolism Ridker PM, Goldhaber SZ, Danielsen E, et al and the PREVENT Investigators New England Journal of Medicine 2003; 348:15 Long-Term Low-Intensity Warfarin Therapy for the Prevention of Recurrent Venous Thromboembolism Ridker PM, Goldhaber SZ, Danielsen E, et al and the PREVENT Investigators New England Journal of Medicine 2003; 348:15 Acute DVT Duration of Anticoagulation

Long-Term Low-Intensity Anticoagulation Major Study Endpoints 2.1 yrs. mean) Ridker PM, et al NEJM 2003; 348:15 Ridker PM, et al NEJM 2003; 348:15 Recurrent DVT Major Bleed Death Composite Recurrent DVT Major Bleed Death Composite < < % -253% 50% 48% 62% -253% 50% 48% RRR P-value 14.6% 0.8% 0.32% 16.2% 14.6% 0.8% 0.32% 16.2% Placebo (n = 253) Placebo (n = 253) 5.5% 1.9% 0.16% 8.6% 5.5% 1.9% 0.16% 8.6% Warfarin (n = 255) Warfarin (n = 255)

Ridker PM, et al NEJM 2003; 348:15 Long-Term Low-Intensity Anticoagulation

Ridker PM, et al NEJM 2003; 348:15 Long-Term Low-Intensity Anticoagulation

Acute DVT: Anticoagulation 738 patients Rx’ed ≥ 3 mos for VTE Randomized –Warfarin INR 2.0 – 3.0 –Warfarin INR 1.5 – 1.8 Followed average 2.4 years Endpoints: Recurrent VTE Bleeding 738 patients Rx’ed ≥ 3 mos for VTE Randomized –Warfarin INR 2.0 – 3.0 –Warfarin INR 1.5 – 1.8 Followed average 2.4 years Endpoints: Recurrent VTE Bleeding Low-Intensity vs. Conventional Kearon, et al NEJM 2003;349:631-9 Kearon, et al NEJM 2003;349:631-9

Acute DVT: Anticoagulation Low-Intensity vs. Conventional Death Any bleed Major bleed Recurrent VTE P-valve Hazard Ratio Conven Low No. per 100 person years Kearon, et al NEJM 2003;349:631-9 Kearon, et al NEJM 2003;349:631-9

Acute DVT: Anticoagulation Low-Intensity vs. Conventional Ridker PM, et al NEJM 2003; 348:15 Risk Reduction of Recurrence Low Intensity Conventional 64% 95% No difference in bleeding complications Kearon, et al NEJM 2003;349:631-9 Kearon, et al NEJM 2003;349:631-9