• There are a number of ways to reduce the risk of travel related DVT.  These relate to all types of long haul travel where there are long periods (> 6 hours) of immobility e.g. planes, trains or motor vehicles.

• In general, aspirin is not currently recommended. Aspirin shows good evidence in the prevention of arterial thrombosis but currently there is not enough evidence to support taking aspirin to prevent travel-related DVT. There is also the potential risk of stomach irritation and allergy.

• There is evidence that shows prophylactic use of graduated compression stockings during air travel reduces the rate of flight related DVT in the general population. Travellers with an increased risk of DVT can consider wearing compression stockings. Stockings must be correctly measured and properly fitted as badly-fitting stockings can actually increase the risk of DVT.

• Regular exercise or mobility on long-haul journeys is recommended, with walking around as much as possible and exercising. Loose-fitting clothing, around the waist and lower legs is recommended.

• In those travellers with an increased risk of DVT, LMWH can be considered in reducing the risk of DVT, usually after discussion with a specialist.

• It is recommended that on long-haul journeys good hydration is maintained at all times, avoiding excessive alcohol consumption.

Fit to fly

• The final decision on a person’s fitness to fly rests with the airline. However, it is a common for patients to request a declaration from their doctor to support them in their travels. Such requests fall outside the remit of the National Heath Service (NHS) primary care and are chargeable.

Resource

• Godden A. Passenger fitness to fly. InnovAiT 2021; 14(9): 540–545.

• Air travel - health issues (fitfortravel)

• DVT prevention for travellers (CKS)

• Compression stockings for preventing deep vein thrombosis (DVT) in airline passengers (Cochrane)