It’s the holiday season and a time when we hear lots of questions about how to reduce the risk of leg blood clots and travel. It is well known that long-distance travel confers a small increased risk of venous thromboembolism (VTE) such as deep venous thrombosis (DVT) or pulmonary embolism (PE). The rates are higher in those who travel for prolonged periods, and are greatest in the first two weeks after travel.
Patients at an increased risk for blood clots in general include:
- A previous blood clot
- Family history of blood clots
- Known clotting disorder
- Recent surgery, hospitalization, or injury
- Use of estrogen-containing birth control or hormone replacement therapy
- Current or recent pregnancy
- Older age (risk increases with age)
- Active cancer (or undergoing chemotherapy)
- Other serious illnesses, including congestive heart failure or inflammatory bowel disease
- Limited movement (like being in a leg cast)
Who is at Risk?
We are often asked who is at risk, and what they can do to try to minimize risks. All travelers, regardless of risk, should avoid dehydration and frequently exercise leg muscles while traveling. Travelers on a flight or drives of less than 6 hours and those with no known risk factors for blood clot risks, regardless of the duration of the flight, do not need DVT prophylaxis. Travelers with 1 or more risk factors for blood clots should consider wearing graduated compression stockings while traveling. They should also stop frequently to get up and move their legs. Blood thinners are not generally prescribed to prevent clots in this setting, except in less common circumstances of patients with known clotting disorders. If you are on blood thinners, also known as anticoagulants, be sure to follow your doctor’s recommendations on medication use.
What to watch for?
The typical signs and symptoms of a blood clot include leg swelling, redness, pain in the calf or thigh. Its usually in one leg, but can be in both. In some case, one might have chest pain, which can indicate a clot has broken free in the veins and traveled to the lungs. This is know as a pulmonary embolism. If you suspect a blood clot, its important to seek medical attention in an emergency setting or call 911. Once at the hospital or clinic, the care providers will take your history, evaluate your complaints and will often obtain a venous ultrasound which can visualize the deeper veins and detect a clot in most cases.