Venous disorders

Deep venous thrombosis (DVT)

Patients with DVT can, from a medical point of view, fly after 3-5 days as long as the local symptoms are decreased and that they are in sufficient anticoagulation therapy. The patients may not have any symptoms of pulmonary embolism. Knee-long graduated compression stockings are recommended. Normally, the patients can fly sitting and unaccompanied but they should have WCHR in airports. On prolonged flights, the patients must be able to sit with the leg elevated.

There are 3 different types of anticoagulation therapy that can be recommended in treating patients with DVT:

• LMWH (Low Molecular Weight Heparin).   

   Already 24 hours after the first injection, the anticoagulation therapy is sufficient.

• VKA (Vitamin K Antagonist – warfarin or coumarin).

   The anticoagulation treatment is first sufficient when the INR has been in level (between 2 and

   3) for 48 hours. This often takes a week.

• NOAC (New Oral Anticoagulant Drugs).

   All NOAC drugs are very effective and the anticoagulation therapy is nearly sufficient after the

   first tablet and definitive after 24 hours.

   Still, the airline company’s requirements for allowing patients to fly after DVT differs, so when

   planning the transport it is advisable to consult the actual airline.

Regarding thromboembolic prophylaxis see Chapter 1.

Pulmonary embolism

Following a smaller pulmonary embolism without a special respiratory effect, the same rules apply to DVT in relation to with scheduled flights.

Patients who have had a larger pulmonary embolism may be transported depending on the respiratory condition. These patients may be more easily desaturated by physical activity, although SAT is acceptable at rest. One must therefore be liberal in prescribing oxygen in flight to these.

Arterial disorders

Hypertension

Patients who are receiving treatment for hypertension are under no increased risk when flying.

Hypertensive crisis

A patient who has received treatment for hypertensive crisis should not travel by air until his or her blood pressure has stabilised at a suitable level and possible attendant cardiac problems have been treated. Patients may normally travel by air, seated and unescorted. Help with baggage and, possibly, a wheelchair should be arranged at the airport in order to avoid physical strain.

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