How would you manage symptomatic, bilateral subsegmental PE developed after long air travel?

The patient takes frequent flights for their job, with no prior history of VTE, and has already been taking measures for prevention including frequent ambulation, hydration, and compression stocking use. Would you recommend limiting long-haul travel? Would you continue anticoagulation even after they stop flying routinely?

Answer from: Medical Oncologist at Community Practice

I generally consider air travel to be a relatively weak provoking factor. Although the 2020 ASH guidelines do not address this, the ASH Guidelines from 2018 on management of VTE cite a 2.8-fold increased risk for VTE associated with air travel, which is roughly similar to the increased risk associat...

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at Duke University
If the patient declines lifelong anticoagulation a...

Answer from: at Academic Institution

This is a very controversial topic, which is difficult to study and thus lacks significant evidence upon which to base firm recommendations. There is a systematic review that one could take a look at, which summarizes the current state of knowledge (Philbrick et al., PMID 17351849). Current ASH guid...

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at Cedars-Sinai Medical Center
Air travel, except with other risk factors, should...

at Alaska Area Native Health Service
As for many other important questions in medicine,...

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How would you manage symptomatic, bilateral subsegmental PE developed after long air travel?

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