Prevent Traveler's Thrombosis on Long Holiday Journeys

Travelers facing long journeys during the holiday season are being urged to take precautions against a condition known as traveler's thrombosis. This condition involves the formation of blood clots during periods of prolonged immobility, typically in trips lasting four hours or more. While the absolute risk remains low for the general population, the combination of sitting still for long durations, limited leg movement, and dehydration can significantly raise the risk of venous thrombosis, particularly in the lower limbs.

Experts highlight that the risk begins before boarding and continues after arrival. The condition occurs when a clot forms inside a vein, obstructing blood circulation. Vascular surgeon Henrique Lamego Junior notes that sitting for long periods disables mechanisms that help blood return to the heart, increasing blood stasis. Factors such as tight seats, prolonged bending of the hips and knees, and reduced oxygen levels on airplanes contribute to the problem. To mitigate these risks, specialists recommend specific exercises, hydration, and the use of compression stockings. Furthermore, vigilance is required after the trip, as symptoms like asymmetric swelling or breathing difficulties can signal serious complications.

The holiday season often involves crowded airports and hours spent sitting in airplanes, buses, or cars. During these long journeys, experts warn of traveler's thrombosis, a condition associated with blood clot formation after hours of immobility. Although the absolute risk is low for healthy people, doctors explain that a combination of prolonged sitting, minimal leg movement, dehydration, and individual factors can favor venous thrombosis, especially in the lower limbs.

Thrombosis occurs when a clot forms inside a vein, hindering or blocking blood circulation. In travel scenarios, the problem is directly linked to reduced blood flow in the legs. Henrique Lamego Junior, a vascular surgeon, explains that when a person remains still, the body stops using important mechanisms that help blood return to the heart. He states, "If I am staying still, I lose those two other contributions to blood return, I increase blood stasis, which is the decrease in flow."

In practice, this slowing of blood flow favors the dilation of veins and creates an environment conducive to the formation of a trombo—the solidification of normal blood constituents that results in a clot. The risk becomes relevant for trips lasting about four hours, especially on flights. Factors contributing to the issue include:

• Tight seats
• Compression behind the knee
• Prolonged flexion of the hip and knee
• Slight reduction in blood oxygenation on commercial flights

According to Lamego Junior, "from four hours, the risk increases for having deep venous thrombosis on flights."

Certain groups of people face a higher risk of developing thrombosis during travel. Those who have had previous blood clots, smokers, individuals with obesity, sedentary people, and patients with active cancer are among the groups requiring extra attention. Additionally, women using oral contraceptives and men using testosterone are at increased risk. Age is also a factor; the risk rises as people get older, particularly after the ages of 45 or 60.

Angiologist Caio Cesar Martins Focassio highlights that prolonged immobility is often accompanied by another aggravating factor common in travel: dehydration. He explains, "Drinking water helps keep the blood less viscous and improves circulation. In travel, especially by plane, people tend to drink less fluids, which increases the risk." The consumption of alcohol and caffeine, which is frequent during long trips, can also contribute to fluid loss.

Furthermore, one of the main fears associated with thrombosis is the possibility of it evolving into a pulmonary embolism. This occurs when part of the clot breaks off and migrates to the lungs. Consequently, deep vein thrombosis and pulmonary embolism are viewed as manifestations of the same problem: venous thromboembolism (VTE). According to Focassio, many thrombosis cases can evolve with some degree of embolism, sometimes silently. He notes, "Fortunately, many times this process can be asymptomatic."

The good news is that simple measures help reduce the risk. The primary strategy is movement. Even while seated, it is possible to activate circulation with basic exercises, such as moving the feet back and forth, rotating the ankles, and alternating the elevation of heels and toes. Whenever possible, standing up and walking for a few minutes during the trip also makes a difference.

Another important ally is elastic compression stockings. They help reduce venous stasis and improve blood return to the heart. Vascular surgeon André Estenssoro explains that graduated compression prevents blood from accumulating in the legs during long periods of sitting. He says, "Compression stockings are excellent allies in the prevention of venous thrombosis." While the indication and ideal type vary based on the traveler's profile, they are generally considered for trips starting at three to four hours.

However, caution must continue after disembarking. Experts warn that symptoms may appear days or even weeks after the trip, being most common in the first two weeks. Warning signs include:

• Persistent swelling, especially if one leg is more swollen than the other
• Localized pain
• Hardening of the calf
• Changes in skin color

Lamego Junior emphasizes that asymmetry is a key point: "If the edema or this increase in volume is asymmetric, one limb much more than the other, you certainly need to seek medical attention."

Beyond symptoms in the legs, signs such as sudden shortness of breath, chest pain, coughing up blood, or fainting require immediate medical attention, as they may indicate a pulmonary embolism. Although traveler's thrombosis is considered a low risk for the general population, early diagnosis makes all the difference in avoiding serious complications.

During the holiday and vacation period, the medical recommendation is clear: planning a trip includes taking care of one's health. Maintaining hydration, moving the body throughout the journey, and being attentive to the body's signals are simple measures that help transform the holiday trip into a safer journey, from boarding to arrival at the destination.