282 Ch 281. Venous Thromboembolism (DVT/PE) and Chronic Venous Disease

靜脈血栓栓塞 (VTE) = 深部靜脈血栓 (DVT) + 肺栓塞 (PE)，是全球第三大血管性死因；Virchow’s triad: stasis + hypercoagulability + endothelial injury；Wells score + D-dimer 是診斷分流；duplex US 是 DVT 標準，CTPA 是 PE 標準；risk-stratify PE: 5 級 (massive/high-risk → submassive intermediate-high → submassive intermediate-low → low-risk → very-low)；massive PE → thrombolysis (alteplase or 半量) ± catheter-directed lysis + 機械性血栓清除 (FlowTriever)；DOAC 是大多數族群首選（rivaroxaban、apixaban、edoxaban、dabigatran），warfarin 用於 antiphospholipid syndrome、機械瓣；慢性靜脈疾病 (CEAP C1-6) 用 compression + venoactive drugs + 雷射/手術；2024 ESC PE Guideline 整合 PERT (Pulmonary Embolism Response Team) + catheter therapies。