**1. Introduction**

Venous disease continues to increase in number of patients throughout the 2000's. With continued use of venous access devices, dialysis and cancer on the increase and overall patient sedentary life style, we will continue to see more and more venous disease in our population. Overall, venous disease is far more prevalent in the population than arterial disease. However, it is less diagnosed than arterial disease due in part too less acute symptomatology. Patients tend to present later in their disease process due to a multitude of factors including lack of debilitating symptoms, non-life threatening presentation and manageable discomfort until later stages.

Symptoms like gradual leg swelling in DVT patients, arm swelling in Dialysis fistulas and facial edema in superior vena cava (SVC) syndrome are slowly progressive until symptoms become debilitating. Even pulmonary emboli can be sub clinical with only non-specific findings like dyspnea and chest discomfort. Coumadin and the other low molecular weight heparin products are used as outpatient therapies in oral or injection preparations. These are adequate therapies for further prevention of clot formation and help resolve clots outside the hospital setting. However, weekly blood draws and side effects of these drugs particularly in the elderly can be significant and are potential reasons for multiple readmissions to the hospitals related to complications from bleeding.
