TRAVELERS DEEP-VEIN THROMBOSIS - 16 CASES

The term of economy class syndrome has been used to describe the deep vein thrombosis which may follow air travel. The mechanisms suggested for this include tendency to clot formation in the legs secondary to t he reduced venous return induced by the sitting position with direct c ompression of popliteal and femoral veins, and secondary to dehydratio n and haemo-concentration. However, these conditions are also observed with others means of transport. We describe 16 patients with deep vei n thrombosis following travel by bus, car, truck and train. These 16 p atients represent 3.4 percent of 465 patients with thromboembolism man aged over a 52-month period in our department. All but one patients ha d one or more risk factors for deep vein thrombosis. The mean duration of the trip was 14.2 hours and the first symptom occurred less than a week after the journey in 75 percent of the patients. These first sym ptoms suggested deep vein thrombosis in 8, pulmonary embolism in 5, an d deep vein thrombosis with pulmonary embolism in 3 patients. Regular non alcoholic drinks and regular walks seem to be sufficient to preven t deep vein thrombosis in the great majority of travellers. However, l ow dose heparin on a temporary basis or elastic stockings could be con sidered in high risk subjects.