From the Guidelines
It is recommended to wait at least 2-4 weeks after a DVT diagnosis before flying, and to consult a doctor before flying if it's unavoidable to fly sooner. The risk of DVT recurrence or complications is higher during this period, and flying can increase this risk due to prolonged immobility, dehydration, and lower cabin pressure 1. Before flying, it's essential to ensure stability on anticoagulation therapy, such as warfarin, rivaroxaban, apixaban, or low molecular weight heparin, as prescribed by a physician.
During the flight, several preventive measures can be taken to reduce the risk of DVT recurrence or complications, including:
- Staying hydrated by drinking plenty of water
- Avoiding alcohol and caffeine
- Performing regular leg exercises, such as ankle rotations and toe raises
- Walking around the cabin every 1-2 hours
- Wearing compression stockings with a pressure of 15-30 mmHg
- Considering a prophylactic dose of anticoagulant before long flights if recommended by a doctor 1
These guidelines aim to minimize the risk of DVT recurrence or complications, and it's crucial to follow a doctor's specific advice, as they can tailor recommendations to an individual's particular medical situation. The American Society of Hematology guidelines also recommend the use of graduated compression stockings or low-molecular-weight heparin in long-distance travelers who are at high risk for VTE 1. However, the most recent and highest quality study 1 provides more specific guidance on traveling with heart failure and the associated risk of DVT, emphasizing the importance of risk assessment and practical recommendations for patients with incident heart failure.
From the Research
Guidelines for Flying after DVT
The guidelines for flying after having a Deep Vein Thrombosis (DVT) are not explicitly stated in the provided studies. However, we can gather some information related to the treatment and management of DVT that may be relevant to flying.
Treatment and Management of DVT
- Patients with DVT should be treated with a 5- to 7-day course of heparin or low-molecular-weight heparin (LMWH) 2.
- Oral anticoagulants can be started within 24 hours of the initiation of heparin or LMWH, and the treatment duration is typically 3 months or indefinitely, depending on the individual risk of recurrence and bleeding 3, 4.
- The risk of recurrence after stopping therapy is largely determined by whether the acute episode of VTE has been effectively treated and by the patient's intrinsic risk of having a new episode of VTE 3.
Travel-related Venous Thromboembolism
- Travel-related thromboembolism reflects the relationship between venous thromboembolism (VTE) and long-haul flights, and travelers should be evaluated for the risks for thrombosis 5.
- Direct oral anticoagulants (DOACs) are currently the standard treatment for VTE and a prophylactic measure for VTE in orthopedic surgery, and may be used to treat travel-related VTE, although the data are lacking 5.
Recommendations for Flying after DVT
Although there are no specific guidelines for flying after DVT, it is recommended that patients with a history of DVT take precautions to reduce their risk of recurrence, such as:
- Wearing compression stockings
- Staying hydrated
- Avoiding long periods of immobility
- Moving regularly during the flight It is essential to consult with a healthcare professional before flying, especially if you have a history of DVT, to determine the best course of action and to discuss any specific recommendations or precautions that may be necessary 5.