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For my long distance travels, to avoid thrombosis, I used to frequently move during the flights and try to book a seat in an aisle which helps stretching my legs.

Are there any other preventive measures known to reduce the risk of thrombosis during long haul flights? Is it worth taking one of those antithrombotic drugs (such as Fragmin), which are given in the hospital for people, who can't move?

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I had the same concern and asked my family doctor. He showed me the recommendations from the American College of Chest Physicians. Below you can find an extract:

VTE = Venous Thromboembolism (includes Pulmonary Embolism, Deep Vein Thrombosis)

GCS = Graduated compression stockings

6.0 Persons Traveling Long-Distance

6.1.1. For long-distance travelers at increased risk of VTE (including previous VTE, recent surgery or trauma, active malignancy, pregnancy, estrogen use, advanced age, limited mobility, severe obesity, or known thrombophilic disorder), we suggest frequent ambulation, calf muscle exercise, or sitting in an aisle seat if feasible (Grade 2C).

6.1.2. For long-distance travelers at increased risk of VTE (including previous VTE, recent surgery or trauma, active malignancy, pregnancy, estrogen use, advanced age, limited mobility, severe obesity, or known thrombophilic disorder), we suggest use of properly fitted, below-knee GCS providing 15 to 30 mm Hg of pressure at the ankle during travel (Grade 2C). For all other long-distance travelers, we suggest against the use of GCS (Grade 2C).

6.1.3. For long-distance travelers, we suggest against the use of aspirin or anticoagulants to prevent VTE (Grade 2C).

You can find the complete version here: http://www.chestnet.org/Guidelines-and-Resources/CHEST-Guideline-Topic-Areas/Pulmonary-Vascular

Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ. Chest. 2012;141(2_suppl):7S-47S. doi:10.1378/chest.1412S3.

P.S (if like me, you are wondering what the grading means): the grading corresponds to the level of "evidence" for this recommendation. Grade 2C means that randomized trials are still missing, and that this decision was made by balancing the risk and benefits of the intervention. This website gives a good explanation of the grade system: http://www.medicographia.com/2011/12/rating-the-quality-of-evidence-and-the-strength-of-recommendationsthe-new-grade-system-in-venous-disease/

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    Hi Felipe! Thank you for this answer, in particular for the guidelines, very useful! I just felt that VTE might be an abbreviation that needs some clarification for a layperson. Hence the edit (hope it is ok for you). Thank you. Best wishes. – S.Victor Aug 10 '16 at 14:19
  • @S.Victor Good idea! Thanks for improving my answer! Cheers ;-) – Felipe Aug 10 '16 at 16:44
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    +1 for the guidelines. I have just also provided an edit to explain the abbreviation GCS... It is not a common abbreviation, so might be worse a short explanation. Best regards. M. Arrowsmith – M. Arrowsmith Aug 11 '16 at 12:58
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If you are overall healthy, I don't think it would be wise to go so far as to use an antithrombotic drug; as that will also thin your blood and may cause other issues.

There are a variety of dietary supplements that claim to aid in circulation; however, I can't prove that they will - or won't - work.

So, my best advice would be to obviously, get up and move when you can. Since that isn't always possible, I will give you some ideas for stretches you can do that won't take up too much space.

You can tap your feet and circle your ankles. Try not to cross your legs; however, most of us do - especially if we're on a long trip -, so at least try to frequently change your leg position. If you are sitting in a seat that causes your feet not to touch the floor/ground, try to keep your legs swinging and again, change positions as often as possible. Try to keep your legs from falling asleep, that would certainly be a sign that you've been in one position for too long.

If you have never had a thrombus (DVT) before, some things to watch for are: swelling in one and, rarely, both legs; as well as pain that feels something like a cramp. If the clot moves to your lung, which is a risk, you can expect to feel non-radiating chest pain and difficulty breathing. If you would like additional information on DVT as well as some preventative measures, please see the provided links.

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