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Studies of the pathophysiologic mechanisms for the increased risk of venous thromboembolism or VTE after long-distance travel have not produced consistent results, but venous stasis appears to play a major role; other factors specific to air travel may increase coagulation activation, particularly in passengers with individual risk factors for VTE.
Numerous medications have been shown to reduce the risk of a person having a VTE, however careful decision making is required in order to decide if a person's risk of having a VTE outweighs the risks associated with most thromboprophylaxis treatment approaches (medications to prevent venous thrombosis).
Dozens of genetic risk factors have been identified, [14] and they account for approximately 50 to 60% of the variability in VTE rates. [4] As such, family history of VTE is a risk factor for a first VTE. [88] Factor V Leiden, which makes factor V resistant to inactivation by activated protein C, [88] mildly increases VTE risk by about three times.
Virchow's triad or the triad of Virchow (/ ˈ f ɪər k oʊ /) describes the three broad categories of factors that are thought to contribute to thrombosis. [1] Hypercoagulability; Hemodynamic changes (stasis, turbulence) [2] Endothelial injury/dysfunction; It is named after the renowned German physician Rudolf Virchow (1821–1902). However ...
Primary prophylaxis with low-molecular weight heparin, heparin, or warfarin is often considered in known familial cases. Anticoagulant prophylaxis is given to all who develop a venous clot regardless of underlying cause. [6] Studies have demonstrated an increased risk of recurrent venous thromboembolic events in patients with protein C deficiency.
The mainstay of VTE management is anticoagulation therapy, which prevents thrombus propagation and embolization. Such treatment reduces the risk of recurrence. [5] [4] [1] The choice and duration of anticoagulation depend on the individual patient's risk factors, bleeding risk, and preferences.
Generally speaking the risk for thrombosis increases over the life course of individuals, depending on life style factors like smoking, diet, and physical activity, the presence of other diseases like cancer or autoimmune disease, while also platelet properties change in aging individuals which is an important consideration as well.
Venous thromboembolism (VTE), a common risk factor, is present at much higher rates in those over the age of 70 (three times higher compared to those aged 45 to 69). [27] This is likely due to there being a generally lower level of activity among the elderly, resulting in higher rates of immobility and obesity. [27]