Prophylaxis

Since pulmonary embolisms almost always result from a thrombosis, all prophylactic measures for thrombosis apply equally to pulmonary embolism:

Wearing compression stockings before surgery or after childbirth
Use of anticoagulant drugs (e.g. heparin) in OP ́s or oral anticoagulants (e.g. Marcumar) after thromboses
Avoidance of the risk factors mentioned above
In the case of recurrent pulmonary embolisms, a so-called kava screen is inserted – a kind of sieve is implanted in the largest vein leading to the heart (vena cava). This sieve or screen catches the floating thrombi from leg vein thromboses and pelvic vein thromboses so that they cannot enter the lungs.
Regular and sufficient movement to ensure good blood circulation in the leg veins, avoid long sitting with bent legs
Drink enough to avoid thickening of the blood

Pulmonary embolism can affect anyone, although there are certain groups of patients who have an increased risk of getting an embolism.

However, these risk groups can reduce the risk by taking prophylactic measures. If there are diseases that increase the risk of thrombosis (such as cancer, hormonal disorders, mutations around the coagulation system and others), long-term medication with anticoagulants may be indicated. There are different groups of medication, whereby the coumarins are often used here.

In Germany, the coumarin Marcumar® is the most frequently prescribed drug. Since it can be taken orally (through the mouth) and does not have to be injected, it is very well suited for long-term or permanent medication. When taking Marcumar®, it is very important to always keep an eye on the INR value.

It is very important to wear compression stockings, as this prevents blood from accumulating in the legs and forming thrombi. Especially if there are risk factors that cannot be removed, such as the factor V Leiden mutation, unnecessary risk factors such as smoking should be avoided at all costs. Before long journeys, a doctor should be consulted to perform a one-time anticoagulation (anticoagulation) with heparin – especially if the patient has another or more risk factors.

Other very simple prophylactic measures are to avoid sufficient exercise and long periods of sitting. Care should also be taken to ensure that sufficient fluid is drunk.There is no clear consensus on how long after a pulmonary embolism should not be flown. It is usually recommended to wait about 6 months before flying again after pulmonary embolism.

However, the risk of having another pulmonary embolism depends on many factors. A doctor should therefore be consulted who can assess the risk of thrombosis on the basis of the type of pulmonary embolism, the patient’s current condition, previous illnesses and the duration of the flight and advise accordingly. As a matter of principle, however, an attempt should be made to keep the risk of a new pulmonary embolism as low as possible, because the probability of serious consequential damage is high. Therefore, for a prolonged period after pulmonary embolism, care should be taken either to choose destinations in relative proximity or to take precautions to reduce the risk of thrombosis during a flight. These include compression stockings and injection of heparin.