Travel Health – DVT

Travelling by air is now a way of life, especially for those living on an island, but there is increasing awareness that some passengers develop a deep vein thrombosis (DVT) where a clot forms in the leg following long-haul travel (“economy-class syndrome”).

Research suggests that the risk of DVT is doubled by flying for more than 4 hours, but statistically a fit individual would have to fly long-haul every day for 15 years to get a DVT. The risk of this is increased by being overweight, being very tall or short, taking hormonal medication or being pregnant, or taking multiple or very long flights. However, the most important cause of DVT is being immobile for long periods which can lead to pooling and clotting of blood in the leg veins, regardless of whether travel is by air, rail or car.

Deep vein thrombosis may not cause any symptoms at all, but one-sided calf tenderness, swelling or discolouration within a fortnight of flying should alert the traveller. Nowadays a quick blood test and simple ultrasound scan will indicate if there is a DVT or not. Most patients with DVT are treated with warfarin, a blood-thinner, for at least 3 months, and usually make a full recovery.

Many airlines now give general health advice which may include prevention of travel-induced DVT. Moving and stretching arms and legs at regular intervals, not being cramped by luggage placed in front of you, and avoiding dehydration by alcohol or caffeine are often suggested. Walking up and down the aisle may seem like a good idea too, but carries a small risk of injury from unexpected turbulence!

Other recommendations include taking an aisle seat and wearing compression stockings (flight-socks) if a passenger is at higher risk, but these are probably not needed if one is fit and well. Although many travellers “pop” an aspirin before long-haul flights there is no evidence that it protects against DVT, and it may cause stomach irritation in an unlucky few. Finally, purchasing a business-class ticket will please the airline but probably not reduce your very small risk of DVT. For the vast majority of jet-passengers, then, it should be enough to follow the three Ws: Water yourself, Wiggle your toes and feet, and Walk down the aisle carefully!
 
Mr Sudip Ray is a Consultant Vascular Surgeon in London and Jersey. For further information about venous disease contact www.endovein.co.uk or phone 01534 625000