Anticoagulation means using medicines that agent that prevent the formation of blood clots. Until about 2000, prevention and treatment of thromboembolic events such as stroke, deep vein thrombosis, or pulmonary embolism had just a few options, despite the fact that DVT and PE kill more people annually than HIV, breast cancer and traffic accidents combined. Coumadin, which has been around for 75 years, was the mainstay. Today, there have been a number of new agents introduced for these diagnoses and there are more in the pipeline. This creates a dilemma for the doctors, as well as the patients, in deciding which agent to use, for how long, for which problem, and for which patient. The goal of our anticoagulation program is to optimize both clinical benefit and patient safety.