Air travel and risk of venous thromboembolism

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7295.1183/a (Published 12 May 2001) Cite this as: BMJ 2001;322:1183

Passengers should reduce consumption of alcohol on flights

  1. P C Malone (pcmalone@Doctors.org.uk), retired general practitioner
  1. 129 Viceroy Close, Birmingham B5 7UY
  2. Center for Health Promotion and Disease Prevention, Henry Ford Health System, Detroit, MI 48202-3450, USA

    EDITOR—Geroulakos,1 like previous reviewers of the relation between air travel and venous thromboembolism,2 did not mention the theoretical and experimental evidence of thrombogenesis in venous valve pockets that colleagues and I have published.3 Modelled on one of the six possible permutations of Virchow's triad, our experiments produced experimental thrombi in venous valve pockets for the first time since Virchow described them in 1858.4 The specific triad model was (1) interrupted circulation in venous valve pockets causing (2) hypoxaemic metabolic endothelial injury and leading to (3) ectopic haemostatic plug formation (blood metamorphosis) in valve pockets.

    Merely to move blood clotting from position 1 to position 3 in the triad sequence gives a new explanation for thrombogenesis. This suggests that thrombogenesis during long haul flights is attributable to individual passengers' behaviour—specifically, taking an excess of drugs …

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