Prevention of Venous Thrombosis with Elastic Stockings During Long-Haul Flights: The LONFLIT 5 JAP Study

Abstract

The aim of this study was to evaluate deep venous thrombosis (DVT) prophylaxis with specific elastic stockings in long-haul flights (11-13 hours), in high-risk subjects. A group of 300 subjects was included; 76 were excluded for several problems including concomitant treatments; 224 were randomized into two groups (stockings vs. controls) to evaluate prophylaxis with below-knee stockings. An exercise program was used in both groups. Scholl (UK) Flight Socks (14-17 mmHg of pressure at the ankle) were used. DVT was diagnosed with ultrasound scanning. The femoral, popliteal, and tibia] veins were scanned before and within 90 minutes after the flights. Of the 205 included subjects, 102 controls and 103 treated subjects completed the study. Drop-outs were due to flight connection problems. Age, gender, and risk distributions were comparable in the two groups. In the treatment group (103 subjects; mean age, 42; SD 9; M:F, 55:48), one limited, distal DVT was observed (0.97%). In the control group (102 subjects; mean age, 42.1; SD 10.3; M:F, 56:46), six subjects (5.8%) had a DVT. There were no superficial thromboses. The difference in DVT incidence is significant (p<0.0025; six times greater in the control group). Intention-to-treat analysis counts 18 failures in the control group (12 lost to follow-up + six thromboses) of 112 subjects (15.8%) versus eight failures (7.3%) in the treatment group (p<0.05). The tolerability of the stockings was very good and there were no complaints or side effects. All events were asymptomatic. Considering these observations, Scholl Flight Socks are effective in reducing the incidence of DVT in high-risk subjects.

Graduated compression stockings as prophylaxis for flight‐related venous thrombosis: systematic literature review

“…2003a), LONFLIT 4‐3‐b (part II of the trial) (Cesarone et al. 2003a), and LONFLIT 5 (Belcaro et al. 2003).…”

“…Flight‐related thrombosis is believed to be the result of the interaction or combination of these factors, caused by characteristics specific to air travel. Limited leg space on the flight often results in compression of veins, especially the popliteal vein (Belcaro et al. 2003).…”

Prevention of VTE in Nonsurgical Patients

“…All but one of these trials was conducted by a single group of investigators. 140,[143][144][145][146][147][148][149][150] Trials enrolled a mix of low-and increased-risk subjects based on risk factors for VTE, and most studies included persons taking fl ights of . 7 h. Asymptomatic DVT detected by screening ultrasound examination was the primary end point.…”

Air Travel and Venous Thromboembolism: A Systematic Review

“…No studies tested warfarin or unfractionated heparin. Graduated compression stockings, ranging from 12 mmHg to 30 mmHg at the ankle, were evaluated in 6 studies, and 4 of these studies reported a statistically significant benefit 18,26,27,31. Of the 1,237 subjects using compression stockings, only 2 DVTs were found (0.2%), compared to 46 in the 1,245 controls (3.7%).…”