Strategies for Prevention of Travel-associated Deep Venous Thrombosis(DVT)

Spring and summer is travel time in the United States. It is estimated that 60,000 individuals in the United States die each year from pulmonary embolus. Each year, at least 100,000 deaths are attributed to deep venous thrombosis and pulmonary embolisms. How widespread is Deep Venous Thrombosis? Each year, 600,000 patients will encounter some type of venous thromboembolism or Deep Venous Thrombosis. The most Deep Venous Thrombosis is normally in the legs, approximately 70-80% of Deep Venous Thrombosis take place in the thigh region and 20- 30% happen in the calf. However, Deep Venous Thrombosis can simultaneously develop in each leg, causing bilateral swelling. If only one leg is swollen, this is more suspicious for Deep Venous Thrombosis than if both legs are swollen. The symptoms normally related with Deep Venous Thrombosis are discomfort, tenderness, and swelling in the area where the clot takes place, and frequent in ladies as well as men who have experienced leg injuries. It is а clot that forms deep in legs, common among post-surgery patients, frequent to air travelers, hormonal contraception, obesity.

Long duration travel is a weak risk factor for the development of Deep Venous Thrombosis. Deep Venous Thrombosis is a multicausal disorder and the accumulation of risk factors added to an individual’s inherent thrombotic risk determines whether or not thrombosis develops. In clinical practice decisions about thromboprophylaxis are made by considering the patient’s thrombosis risk and the illness or proposed surgical intervention. A similar approach should be taken to travel-related thrombosis where risk is related to pre-existing factors and duration of travel. The data suggest that duration of travel of 3 hours upward is associated with a thrombotic risk. The incidence of symptomatic Deep Venous Thrombosis, most of which are confined to the calf, in low risk travelers after 8 hour flights is around 0.5% and the incidence of early symptomatic pulmonary embolism in all flyers is around 1 in 2 million. To these points the experts proposes as follows recommendations:-

1) Maintaining mobility may prevent Deep Venous Thrombosis and in view of the likely pathogenesis of travel-related Deep Venous Thrombosis maintaining mobility is a reasonable precaution for all travelers on journeys over 3 hours.

2) Travelers at the highest risk of travel-related thrombosis undertaking journeys of greater than 3 hours should wear well fitted below knee compression hosiery. Often, compression stockings are recommended by а doctor to relieve pain, cease swelling, and improve blood circulation. First, before discussing compression therapy, we should distinguish between "Graduated Compression Stockings" and "Anti-Embolism" stockings. Compression stockings could be employed to manage swelling in the legs. Compression stockings, in some circumstances, have been utilized to encourage suitable circulation. If you have to have a greater level of compression, your doctor will know and recommend a level of compression accordingly.

3)      Where pharmacological prophylaxis is considered appropriate, anticoagulants as opposed to anti-platelet drugs are recommended based on the observation that in other clinical scenarios they provide more effective thromboprophylaxis. Usual contraindications to any form of thromboprophylaxis need to be borne in mind.