Deep Vein Thrombosis and Flying

In case of DVT, the main aim of treatment is to prevent complications such as pulmonary embolism.

Pulmonary embolism can range between mild and severe. Mild PE can be treated through anticoagulation using blood thinners, while severe PE requires additional treatments such as clot busters (thrombolytic therapy) or embolectomy, which is a procedure in which the clot is removed with the help of a catheter or surgery.

A combination of two blood thinners are used in the beginning of anticoagulation therapy. They are heparin, which is administered to the patients through injection and warfarin, which is an oral blood thinner.

Heparin is available in two forms. The traditional unfractionated form has no fixed dose and requires intravenous administration. The recent forms of heparin include the low-molecular forms which are prescribed in accordance to the patient’s weight and need to be injected into the patient once or twice on a daily basis. These forms of heparin have begun to replace the traditional forms. The treatment of warfarin is overlapped with heparin treatment until the former becomes effective. The duration of warfarin administration is a controversial area. The present recommendation is a 6-month therapy but it can vary with the patient’s needs.

Patients may need their International Normalized Ratio (INR) checked every few weeks or months to avoid side effects of warfarin.

A person with PE is usually treated in the hospital while a DVT case can be managed on an out-patient basis.

In individuals who are unable to tolerate anticoagulation or in those for whom anticoagulation fails, a permanent metal filter may be inserted into the inferior vena cava (large vein below heart). This filter would then be able to stop the blood clots from reaching the pulmonary arteries and causing PE.

The drawback is that these filters do not prevent the clotting process and in turn they themselves may cause clots on or below the filter.

Precautions before Air Travel

If you are likely to travel by air, it is better to take precautions if you think you belong to the risk group.

General precautions are listed below:

Drink lots of water and avoid dehydration

Avoid alcohol and coffee during flight

Avoid sleeping pills as it will restrict your mobility

Avoid tight underwear and wear clothes that will permit easy movement

Keep your leg atop the luggage

Don’t let your thigh press against seat. Slide forward and stretch your legs

Do in-flight exercises whenever possible


Take a walk around the cabin when possible

Wear stocking if necessary

Discuss with your doctor about using blood thinners