Traveller’s Thrombosis

What is traveller’s thrombosis

Venous thrombo-embolism (VTE). It is a condition where a blood clot develops in the leg veins after long distance travel. It can occur in any class of travel and even on land based journeys as it is caused by prolonged immobility and cramped conditions.

The blood clot causes pain, warmth and swelling in the legs. In some cases the clot travels to the lungs and causes a blockage of the blood vessels there; this will cause difficulty in breathing. If the clot is large enough, sudden death can ensue. The actual risk is very low for most people. However, it is wise to seek medical advice should you experience any of the below symptoms after a long journey.

How to reduce your risk

Ask your travel agent about a stopover — if your travelling time is greater than 4 hours you are at greater risk

Assessing your risk — speak to your doctor before you plan a long-distance trip or if you travel frequently. He or she can assess your individual risk factors and recommend appropriate preventive measures.

In general, risks factors for VTE include:

  • A history of previous VTE
  • Smoker
  • Active malignancy, gross obesity, marked immobility
  • Lower limb injury, especially fractures in a cast
  • Persons with clotting abnormalities
  • Older age (over 60)
  • Large varicose veins
  • Travellers on oestrogen containing oral contraceptives or hormonal replacement therapy (HRT)
  • Pregnancy
  • Recent surgery (within the last 6 weeks), stroke or heart attack

Prevention — on the plane be sure to:

  • Take regular walks around the plane (if allowed)
  • Do isometric exercises of the thighs and calves as shown (see diagram)
  • Luggage should not press on the back of your legs
  • Use a foot rest if available
  • Avoid dehydration by drinking water (1 glass per hour) and avoiding alcohol and caffeinated drinks

Depending on your risks and medical condition, your doctor may also recommend:

  • Below knee graduated compression stockings, which must be properly fitted
  • Aspirin
  • Low molecular weight heparin injections

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