Deep Vein Thrombosis (DVT)

The risk of a clot or Deep Vein Thrombosis (DVT) is small but the event can be life-threatening. It has been described in the popular press as “Economy Class Syndrome” however it is not only associated with flying and may occur after travelling long distances in cramped conditions in buses, trains or cars.

The condition was noticed in the trenches in World War I and in the bomb shelters during the London blitz. Clot production occurs when blood flow is compromised over long periods, particularly where hydration and oxygenation may be reduced as when flying. Muscular activity promotes blood flow and inactivity allows blood to pool. Even the shape of an individual’s leg pressed against a seat may make them more at risk.

• Those travelling longer than 12 hours
• Those travelling repeatedly
• Age over 40 years
• Family history of abnormal clotting
• Malignancy
• Medical issues (heart failure, inflammatory bowel disease)
• Recent major surgery or illness
• Pregnancy or within 6 weeks of delivery
• Those travelling with a plaster cast
• Those will mobility problems
• Overweight travellers (BMI > 30)
• Those on hormone treatments including the pill
• Those who have had previous DVT

Categories of risk are based on the number of risk factors. Multiple risks tend to multiply rather than add up to an even greater risk. Those in a high-risk category need to visit a doctor prior to travel. Blood thinners such as injectable Low Molecular Weight Heparin or oral anticoagulants are available. Compression stockings have also been found to be very effective. Aspirin helps prevent clotting in arteries rather than veins. Decisions on the use of pharmacological prophylaxis should be made on an individual basis.

Apart from identifying whether you are at risk there are some measures which you can take to reduce the risk of deep vein thrombosis.

1. For very long trips ask your travel agent about a stopover.
2. If you have risk factors, consider vascular compression stockings
3. Have an exercise routine while seated. It may seem strange at the time but helps you avoid DVT. All airlines outline these routines in their inflight magazines.
4. Regular ambulation if possible. Seek an aisle seat. Use any short stopover to get out and walk. This stimulates blood flow and moves fluid from the tissues into the vessels.
5. Maintain your hydration by drinking at least 2 to 3 glasses of water per sector. Avoid too much alcohol, tea/coffee and juices as these make you urinate more. The atmosphere in planes is very dry and this can also make dehydration worse.
6. When seated, check that nothing is pressing on the back of your legs.