From the Guidelines
Individuals with Peripheral Artery Disease (PAD) should avoid wearing compression stockings during air travel, as they can further restrict blood flow to the legs, potentially worsening symptoms and increasing risk of complications. The primary concern for PAD patients during flights is maintaining adequate blood flow to the extremities, which is already compromised due to narrowed arteries. While compression stockings are often recommended for preventing deep vein thrombosis in other travelers, they are not suitable for PAD patients due to the potential for further restricting blood flow. According to the American College of Chest Physicians evidence-based clinical practice guidelines 1, compression stockings are recommended for long-distance travelers at increased risk of VTE, but this does not apply to PAD patients. Instead, PAD patients should focus on frequent movement during the flight, such as walking the aisle every 1-2 hours and performing seated leg exercises like ankle circles and calf pumps. Staying well-hydrated, wearing loose, comfortable clothing, and elevating legs when possible can also help maintain circulation. PAD patients should continue taking prescribed medications as directed, particularly antiplatelet drugs like aspirin, clopidogrel, or cilostazol. For long flights (over 4 hours), some physicians may recommend a prophylactic dose of anticoagulant, but this requires individual assessment. The guidelines also emphasize the importance of proper fitting of compression stockings to avoid restricting venous return or causing ulceration 1. However, for PAD patients, the risks associated with compression stockings outweigh any potential benefits, and alternative measures should be taken to maintain circulation during air travel. Key precautions for PAD patients during flights include:
- Frequent movement and exercise
- Staying well-hydrated
- Wearing loose, comfortable clothing
- Elevating legs when possible
- Continuing prescribed medications as directed
- Avoiding compression stockings due to the risk of further restricting blood flow.
From the Research
Precautions for Individuals with Peripheral Artery Disease (PAD) While Flying
Individuals with Peripheral Artery Disease (PAD) should take certain precautions when flying to minimize the risk of complications.
- Compression Stockings: Wearing compression stockings can help reduce the risk of deep vein thrombosis (DVT) and edema during long flights 2, 3.
- Stocking Safety for PAD Patients: A study found that a specific type of compression stocking (VenoTrain angioflow) is safe for patients with PAD and chronic venous insufficiency, as it does not cause skin damage and can improve CVI symptoms 4.
- Flight Duration and Risk: Flights lasting more than four hours increase the risk of DVT, and wearing compression stockings can substantially reduce this risk 2.
- Additional Considerations: While there is evidence to support the use of intermittent pneumatic compression (IPC) devices in the management of PAD, there is limited research on their use during air travel 5.
Key Findings
- High-certainty evidence supports the use of compression stockings to reduce the incidence of symptomless DVT in airline passengers 2.
- Moderate-certainty evidence suggests that superficial vein thrombosis may be reduced by wearing compression stockings during flights 2.
- Compression stockings can also reduce leg edema, with low-certainty evidence supporting their use for this purpose 2, 3.