Travel Related VTE

• What does DVT stand for?

  Deep vein thrombosis
• What is venous thromboembolism (VTE)?

  It is an umbrella term covering diseases from DVT to pulmonary embolism.
• What can long periods of immobility lead to?

  They can slow blood flow and result in pooling and coagulation.
• What can pressure on the popliteal vein cause?

  It can lead to swelling of the affected limb.
• What is a pulmonary embolus?

  It is caused by a blood clot dislodging and traveling to the lungs.
• Can VTE occur in healthy individuals?

  Yes, it can occur spontaneously in otherwise healthy persons.
• What is the misleading term associated with VTE after long-haul air travel?

  Economy class syndrome
• What is the preferred term for VTE related to travel?

  Travel related VTE/DVT or travellers’ thrombosis
• What is the average risk of developing VTE for travelers?

  1 in 4656–6000 passengers
• How much does the risk of DVT increase after long-haul flights?

  It increases two to four fold.
• When do most travel-related DVTs occur?

  Within 1–2 weeks of travel.
• What are some risk factors for travel-related DVT?

  Active malignancy, family history of DVT, older age, extremes of height, and more.
• What is a risk factor related to height for DVT?

  People taller than 1.90 meters or shorter than 1.60 meters.
• Why might shorter people be at risk for DVT?

  They may experience seat edge pressure to the popliteal area.
• What is a risk factor related to obesity for DVT?

  Body mass index greater than 30 kg/m².
• What should be assessed to determine DVT risk in travelers?

  Presence of active malignancy, recent surgery, significant immobility, and risk factors.
• What is considered high risk for travel-related DVT?

  Having two or more risk factors for DVT.
• What general advice should be given to long-distance travelers?

  Avoid long periods of immobility and walk around regularly.
• What should travelers do to maintain fluid intake?

  Maintain at least 250 ml every 2 hours.
• What should travelers do if they develop swollen, painful legs after a trip?

  Seek urgent medical advice.
• What is the recommendation regarding aspirin for DVT prevention?

  Aspirin is not recommended for the prevention of travel-related DVT.
• What are the general measures to reduce the risk of travel-related DVT?

  • Avoid long periods of immobility
  • Walk around regularly (every 2–3 hours)
  • Choose an aisle seat when feasible
  • Perform frequent calf muscle exercises
  • Ensure hand luggage does not restrict leg movement
  • Wear comfortable and loose clothing
  • Avoid tranquilisers or sleeping tablets
  • Maintain normal fluid intake (at least 250 ml every 2 hours)
  • Avoid excessive alcohol consumption
• What advice should be given to someone at moderate risk of travel-related DVT?

  • General measures to reduce DVT risk
  • Use graduated compression stockings providing 15–30 mm Hg of pressure at the ankle
• What advice should be given to someone at high risk of travel-related DVT?

  • Assess suitability for long-distance travel
  • Seek specialist advice if appropriate
  • Recommend delaying or cancelling the trip if necessary
  • General measures to reduce DVT risk
  • Consider low molecular weight heparin if indicated
  • Advise graduated compression stockings
• What should be done if the ankle-brachial pressure index (ABPI) is less than 0.8?

  • Compression stockings are contraindicated
• What should be done if low molecular weight heparin is prescribed alongside aspirin?

  • Aspirin should not be discontinued without specialist advice.