This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Belcaro, G. Articles by Moia, M. Search for Related Content PubMed PubMed Citation Articles by Belcaro, G. Articles by Moia, M. Social Bookmarking                         What's this?

Prevention of Edema, Flight Microangiopathy and Venous Thrombosis in Long Flights with Elastic Stockings. A Randomized Trial

The LONFLIT 4 Concorde Edema-SSL Study

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Maria Rosaria Cesarone

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Sandeep S. G. Shah

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Andrew N. Nicolaides

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

George Geroulakos

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Edmondo Ippolito

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Michelle Winford

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Andrew Lennox

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Luciano Pellegrini

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Rossella Brandolini

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Kenneth A. Myers

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Emilio Simeone

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Peter Bavera

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Mark Dugall

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Andrea Di Renzo

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

Marco Moia

Department of Biomedical Sciences, Irvine2 Vascular Laboratory, G. D'Annunzio University, San Valentino Vascular Screening Project (Pe) Italy, The Vascular Unit Ealing Hospital and Irvine Laboratory, St. Mary's Hospital at Imperial College, London, UK, Monash Medical Centre and Epworth Hospital, Melbourne, Australia

The LONFLIT1/2 studies have established that in high-risk subjects after long (> 10 hours) flights the incidence of deep venous thrombosis (DVT) is between 4% and 6%. The LONFLIT4 study has been planned to evaluate the control of edema and DVT in low-medium-risk subjects. The aim of this study was to evaluate edema and its control with specific flight stockings, in long-haul flights. In the first part of the study 400 subjects at low-medium risk for DVT were contacted; 28 were excluded for several nonmedical problems; 372 were randomized into 2 groups to evaluate prophylaxis with stockings in 7-8-hour flights; the control group had no prophylaxis. Below-knee, Scholl, Flight Socks, producing 14-17 mm Hg of pressure at the ankle, were used in the treatment group. The occurrence of DVT was evaluated with high-resolution ultrasound scanning (femoral, popliteal, and tibial veins). Edema was assessed with a composite score based on parametric and nonparametric measurements. Part II: In this part of the study 285 subjects at low-medium risk for DVT were included and randomized into 2 groups to evaluate edema prophylaxis in 11-12-hour flights; the controls had no prophylaxis while the prevention group had below-knee, Scholl, Flight Socks (comparable to part I).

Results. Part I: DVT evaluation. Of the 184 included subjects in the stockings group and 188 in the control group, 358 (96.2%) completed the study. Dropouts were due to compliance or connection problems. Age/sex distributions were comparable in the groups. Stockings Group: of 179 subjects (mean age 49; SD 7; M:F = 101:78), none had DVT or superficial thromboses. Control Group: of 179 subjects (mean age 48.4; SD 7.3; M:F = 98:81), 4 (2.2%) had a DVT. There were also 2 superficial thromboses. In total, 3.35% (6) subjects had a thrombotic event. The difference (p < 0.002) is significant. Intention-to-treat analysis detects 15 failures in the control group (9 lost + 6 thromboses) out of 188 subjects (7.9%) versus 5 subjects (2.7%) in the stockings group (p < 0.05). All thrombotic events were observed in passengers sitting in nonaisle seats. The tolerability of the stockings was very good and there were no complaints or side effects. Thrombotic events were asymptomatic. No difference was observed in the distribution of events between men and women. The 3 women who had a thrombotic event were taking low-dose, oral contraceptives. Edema evaluation: The level of edema at inclusion was comparable in the 2 groups. After the flight there was a score of 6.7 (3.1) in controls; in the stockings group the score was 2.9 times lower (p < 0.05). The control of edema with stockings was clear considering both parametric (circumference, volume) and nonparametric (analogue scale lines) data. Part II: DVT evaluation. Of the 285 included subjects, 271 (95%) completed the study. Dropouts were due to low compliance or connection problems. Age/sex distributions were comparable in the groups. Stockings Group: of 142 subjects (mean age 48; SD 8; M:F = 89:53), none had DVT or superficial thromboses. Control Group: of 143 subjects (mean age 47; SD 8; M:F = 87:56), 3 had a popliteal DVT and 3 a superficial thrombosis. In total, 4.2% (6) subjects had a thrombotic event. The difference (p < 0.02) between groups is significant. Intention-to-treat analysis detects 14 failures in the control group (8 lost + 6 thromboses = 9.7%) versus 6 (all lost = 4.2% in the stockings group) (p < 0.05). Four of 6 events (3 DVT + 1 SVT) were observed in non-aisle seats. The tolerability of the stockings was very good. No difference was observed in the distribution of events between men and women. Edema evaluation: The level of edema at inclusion was comparable in the 2 groups. After the flight there was a score of 8.08 (2.9) in controls while in the stockings group the score was 2.56 (1.5) (p < 0.005). In conclusion. Scholl Flight Socks are very effective in controlling edema. Also this type of compression is effective in significantly reducing the incidence of DVT and thrombotic events in low-medium-risk subjects, in long-haul flights.

Conclusions: Considering these observations, Flight Socks are effective in controlling edema and in reducing the incidence of DVT in low-medium-risk subjects, in long-haul flights (7-11 hours).

Angiology, Vol. 53, No. 6, 635-645 (2002)
DOI: 10.1177/000331970205300603


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?