Venous Thromboembolism

Prolonged immobilization (>8 hours) increases the risk of lower extremity deep vein thrombosis (DVT), particularly in travelers with risk factors for thrombosis. Nevertheless, flight-related symptomatic pulmonary embolism is rare.To minimize the risk, travelers should be advised to walk around or exercise while sitting by flexing/extending ankles and knees, to drink plenty of fluids and to avoid alcohol. Compression stockings can decrease the risk of asympto- matic DVT. One study found that giving a single dose of a low-molecular-weight heparin or aspirin as pro- phylaxis to travelers at high risk (past history of thrombosis, obesity, malignancy, increased platelets) reduced the incidence of DVT, but there is little evidence supporting this approach.