12.02.10 Dr. Garth Rosenberg Blood Clots and Flying

Risks Associated With Flying & Varicose Veins

read an interesting article in the medical journal Phlebology this month that discussed the risk of developing blood clots in the legs when flying long distances. This dangerous condition is called deep vein thrombosis (DVT) that, if left untreated, can become deadly.

London’s Heathrow airport is one of the world’s busiest, and this article estimates that about 11,000 cases of leg vein clots occur yearly in patients traveling through Heathrow alone. You can see how this can be a huge public health issue considering how many large airports exist throughout the world with so many long haul passengers.

Despite the significant risk of DVT, and the recognition of the health impact by the World Health Organization (WHO), very few airlines actually advise patients on the best methods to reduce the risk of blood clotting. In 2001, WHO set up a comprehensive research program called WRIGHT (WHO Research Into Global Hazards of Travel) to study the links between air travel and venous thrombosis.

Long hours of sitting relatively immobile in an airplane cabin leads to poor flow in the leg veins and, in turn, elevates the risk of blood clots. A clot that travels through the blood stream and blocks a blood vessel in the lung can cause a pulmonary embolism (PE). Depending on the size of the clot, a PE can be life threatening.

In the last three weeks, I have treated two patients who brought this problem to light. One was a businessman who flew round trip to DC from Paris. The other was a woman returning to Washington, DC after her 20th anniversary get-away to Hawaii. Both had significant leg pain and swelling after arrival back to the States. Their ultrasounds showed dangerous deep vein blood clots. Unfortunately, now that the clots have developed, the patients need to be on blood thinners for quite a while, and there is an increased risk of long-term vein damage.

Smoking and use of birth control pills increase the risk of clotting, as does having varicose veins. Despite what people may think, varicose veins that are not causing significant symptoms still, in fact, increase the risk of clotting. VNUS Closure is an excellent method of treating these veins to reduce the risk of blood clot.

Simple methods to reduce the risk of DVT include using good quality support hose, staying well hydrated on the plane, performing leg exercises while sitting, and walking the aisle every few hours. Exercises that use the calf muscles are best, such as toe and heel lifts for several minutes every hour. Modifying medications and avoiding smoking before, during and after travel can reduce risk as well. An interesting video can be seen at How to Prevent Blood Clots while Flying.

If you experience leg pain or swelling after a long plane (car or train) trip, I strongly recommend you see your doctor for an ultrasound of the legs to ensure no clot is present. Timely diagnosis can help reduce both the short and long term health risks.

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