Abstract-We analyzed the distal promoter region of the thrombomodulin (TM) gene (nucleotides Ϫ300 to Ϫ2052) in subjects from the Paris Thrombosis Study (PATHROS), a French case-control study of venous thrombosis, to identify polymorphisms that might modify TM gene expression. Eight novel mutations were found in the 40 DNA samples initially screened. Two of these mutations (Ϫ1748G/C and Ϫ1208/Ϫ1209 del TT) were frequent. One rare transition (Ϫ1166G/A) might have functional consequences owing to its position. These 3 mutations were screened for in the entire study population of 327 patients and 398 controls. None of the 3 was significantly associated with thrombosis. Interestingly, the Ϫ1208/Ϫ1209 TT deletion was associated with varicose veins in the patients. This mutation was in tight linkage disequilibrium with the ϩ1418 C/T change in the coding sequence, a known polymorphism that predicts an