Recurrent Deep Vein Thromboses in an Active-Duty Aviator

BACKGROUND: Deep vein thrombosis (DVT) is a morbid disease that potentially has lethal results, with even further professional ramifications in the aviation community. There are only a few reported cases on outcomes of fliers who developed DVT. As such, more research is needed to assist the aeromedical community in identifying high-risk individuals so that counseling and preventative measures are administered to avoid harmful outcomes.

CASE REPORT: We present a 34-yr-old woman with several pre-existing comorbidities who developed ipsilateral DVTs in her lower extremity while in Oman that required medical evacuation back stateside. Days prior to her long-haul flight overseas, she presented to the local emergency department with right lower extremity DVT similar to a prior one she experienced. A week later, while departing the continental United States, she was evaluated by Emergency Medical Technicians for painful ambulation. After being symptomatic for over a week in country, she was admitted to a local hospital where formal diagnosis was made.

DISCUSSION: Aviators are not as familiar with the risks and consequences of thrombus formation. This case highlights several key points, such as a thorough medical clearance process in conjunction with closed loop communication. A history of DVT with additional susceptibilities requires in-depth education prior to long distance travel. A thorough record review should be conducted on a high-risk servicemember to ensure medical optimization. When making the decision to use medical evacuation, risk stratification must be implemented early to ensure safe return.

Cheng MT, Middel BL, Anderson KD. Recurrent deep vein thromboses in an active-duty aviator. Aerosp Med Hum Perform. 2025; 96(7):586–589.