From the Research
It is generally recommended to wait at least 2-4 weeks after a pulmonary embolism (PE) or deep vein thrombosis (DVT) before flying, as this timeframe allows for initial stabilization and effective anticoagulation therapy to be established, as supported by the most recent study 1. When considering air travel after a PE or DVT, several factors come into play, including the risk of clot extension or new clot formation due to reduced cabin pressure and prolonged immobility during flights.
- Before flying, patients should be on appropriate anticoagulation medication, such as warfarin with a therapeutic INR, or a direct oral anticoagulant (DOAC) like apixaban, rivaroxaban, dabigatran, or edoxaban at the prescribed dose, as shown in studies 2, 3, 1.
- During the flight, it's essential to stay well-hydrated, avoid alcohol, perform regular calf exercises, and consider wearing compression stockings (20-30 mmHg), as these measures can help reduce the risk of clot formation.
- For flights longer than 4 hours, getting up and walking around every 1-2 hours when possible is recommended, as this can help mitigate the effects of prolonged immobility. The concern with flying too soon after a PE or DVT is that the reduced cabin pressure and prolonged immobility during flights can increase the risk of clot extension or new clot formation, highlighting the importance of careful consideration and consultation with a healthcare provider before making travel plans, as individual circumstances may require different recommendations based on the severity of the condition, response to treatment, and other risk factors, as noted in studies 4, 2, 3, 1.