Avoiding DVT when flying
Deep vein thrombosis can be a serious condition that often affects people on long flights
Source: Published: February 03, 2020 10:33Peter Feely, Editor Commercial Publishing
Deep vein thrombosis (DVT) is a blood clot that occurs in a vein deep in the body. Most cases happen in the lower leg or thigh and if the vein swells, the condition develops into thrombophlebitis. Dr Deena Mohammed AlQedrah, Consultant and head of vascular and endovascular section at Rashid Hospital, Dubai Health Authority, says that DVT can be a serious.
“It can cause a pulmonary embolism, which can be a fatal complication,” she says. “The clot happens in the vein in the lower limbs. If the clot occurs, especially in the thigh or the pelvis, movements or muscle contractions in the lower limbs can cause the blood clot to move with the blood, upwards, against gravity, and stick to the pulmonary vessels. This can cause a pulmonary embolism, which can shut off the pulmonary circulation, causing no oxygen being sent to the blood, which can be fatal.”
Dr AlQedrah says that DVT can be caused by a number of different factors. “There are many reasons for blood clots but the main is the leg being immobilised for several hours, which is why one of the common causes is long distance flights. The blood circulation becomes very slow and causes blood clots.
“Another risk factor is a history of DVT because the blood where the clot happened is very fragile and the lining of the blood vessel is unhealthy, making the person more prone to another clot.”
Other risk factors include physical injuries and hormone treatments, such as women who take birth control medication, which makes them more prone to clots. Cancer is also a risk factor.
Long haul flights
If you are travelling on a long haul flight, Dr AlQedrah says that sensible precautions can significantly reduce your risk of DVT. “If you are on a long flight to destinations such as America, which can be 12 to 14 hours, I would advise passengers to stand up and walk around at least every two hours. If you are obliged to stay seated, I would suggest small foot exercises, to keep the blood circulation moving.
"There are many reasons for blood clots but the main is the leg being immobilised for several hours, which is why one of the common causes is long distance flights." - Dr Deena Mohammed AlQedrah, Consultant and head of vascular and endovascular section, Rashid Hospital, DHA
“People who are flying should also avoid dehydration. When you travel, if you include the amount of time you spend travelling to and from the airport as well as the flight itself, it can often be more than half a day, so it’s important to remember to drink water.”
Another precaution travellers can take is wearing compression stockings. “One of the prophylactic treatments is wearing compression stockings or socks. They squeeze the calves, creating pressure, and the socks maintain the pressure, imitating a muscle contraction, to avoid a clot formation in the veins,” says Dr AlQedrah.
Signs and symptoms
If you are experiencing DVT, the primary symptom is a sharp pain in the affected area. “If a clot occurs, then the first symptom will be sharp and sudden pain in the affected limb. This will later progress to swelling of the affected limb. It can be so painful that it makes it difficult to stand-up, walk and mobilise and the patient has to seek medical advice.”
At DHA, people who are suspected of suffering from DVT are subjected to an ultrasound scan of the affected limb. If diagnosed with DVT, the patient will be treated with medication and in some cases, a surgical intervention will be carried out. “We will then provide the patients with blood thinning medication, which will help them avoid further clotting of the blood. We do not prescribe medication to dissolve the clot but to avoid further clotting.” says Dr AlQedrah.
“We may also elevate the patient’s leg in the hospital for a few days until they are stable enough to be discharged and continue their treatment at home. We can also carry out a thrombectomy, which is an intervention where the patient doesn’t require a general anaesthetic. This is not used for everyone but for certain people, such as when their limb is threatened. If the clot becomes too big then it can affect the viability of the limb.
“This isn’t used for every patient because it can also cause complications as we use clot-dissolving materials, which may carry some risk for older patients because it might cause bleeding somewhere else.”
Patients who develop CVD will eventually develop post-thrombotic syndrome or postphlebitic syndrome. “In the vein that has the thrombus [clot], the wall gets destroyed and patients will experience on and off swelling and pain in the leg for the rest of their lives. They will also need to wear the stockings,” says Dr AlQedrah.
“If we remove the clot immediately, there will be no long-term damage to the vein, which is why we often decide to carry out a thrombectomy on young and active patients.”
Dr AlQedrah says that it’s always best for people to take precautions to avoid blood clots but she says that, if someone does suspect they have DVT, they should seek a professional opinion immediately. “Since the consequences of DVT can be dangerous or fatal, healthcare providers and patients should be vigilant for a pain or swelling in one leg and this should be diagnosed as DVT until proven otherwise.”