Deep Vein Thrombosis After Air Travel
is a summary of the paper:
Travel: A randomised trial to assess the incidence
of asymptomatic DVT and prevention by graduated
J Scurr, SJ Machin SJ, S Bailey-King, IJ Mackie,
S McDonald , Coleridge Smith PD,
Lancet 12th May 2001.
is the most detailed paper to date on this subject
and has been provided to assist with your understanding
and to offer advice on what to do whilst flying.
purpose of this study was to try to establish
whether people flying long-haul developed clots
in the leg. A lot of anecdotal information has
been provided and there is now genuine concern
that flying may cause clots, some of which can
be very serious. Using a very sensitive technique
we were able to detect very small clots in 12
out of 100 passengers flying long-haul. All these
clots were small and in most passengers dissolved
without treatment. In the remaining passengers
anti-coagulants were given and the clots all dissolved
before they became important. What this study
has shown is that it is extremely common to develop
small clots. We still do not know how many passengers
will go on to get a bigger clot, either affecting
the leg on a long-term basis, or travelling to
the lung. At the same time we studied these passengers,
a further 100 passengers were fitted with Medi-travel
elastic stockings. these stockings squeezed the
leg, promoting blood flow through the deep veins
and preventing the deeper veins from enlarging
during long periods of inactivity. We were unable
to detect any clots in the deep veins in these
100 passengers, suggesting that the use of the
Medi-travel elastic stockings is a very effective
way of preventing the development of clot.
of the passengers wearing elastic stockings complained
of pain in the superficial veins. These passengers
had quite marked varicose veins. It is probable,
therefore, that passengers with bad varicose veins
are prone to the stocking rubbing on the veins
and causing inflammation locally. Superficial
thrombophlebitis is not a serious condition although
it can be quite painful.
summary, passengers who fly long-haul are at risk
of developing small clots. It is probable that
a number of these passengers will go on to develop
bigger clots and more serious problems. The use
of an elastic compression stocking (Medi-travel)
is an effective way of reducing this risk.
- preventing deep vein thrombosis
Following this study and a proven link between
air travel and the development of deep vein
thrombosis, we would make the following recommendations:
Any passenger with a history of clots or co-existing
medical problems such as heart trouble, lung
trouble, cancer or a recent operation should
consult their own general practitioner before
travelling. Your general practitioner can assess
whether there is a real risk and advise you
passengers in good health, then we would make
the following recommendations:
Before travelling obtain a pair of Medi-travel
elastic stockings (www.mediuk.co.uk). These
should be worn for the duration of the flight,
both outbound and inbound. Before getting on
the aeroplane take a reasonable amount of exercise
and avoid drinking alcohol.
When on the aeroplane drink plenty of water
and avoid excessive consumption of alcohol.
Whilst you are sitting in your seat, move your
feet up and down regularly and if you can get
out of your seat, walk round the aeroplane.
If you are not walking round your aeroplane
and you are in your seat with your seatbelt
fastened, moving the feet up and down does promote
the flow of blood through the legs, particularly
if you are wearing an elastic compression stocking.
believe these simple measures are effective in
reducing the risk of developing even a small blood
clot, and certainly effective in reducing the
risk of developing a large blood clot.
All these treatments! Which is the one for
Philip Coleridge Smith DM FRCS
Reader in Surgery, UCL Medical School, London .
Consultant Vascular Surgeon – BVI Medical
The West London Vein Clinic: Tel 0870 609 2389