Download PDF
Semin Thromb Hemost
DOI: 10.1055/s-0045-1805038
Review Article

Fright of Long-Haul Flights: Focus on Travel-Associated Thrombosis

Emmanuel Papadakis
1   Ob/Gyn Hematology, Thrombosis and Hemostasis Clinic, Genesis Hospital, Thessaloniki, Greece
,
Eleni Gavriilaki
2   2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Nikolaos Kotsiou
2   2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Antonella Tufano
3   Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
,
Benjamin Brenner
4   Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Travel-related thrombosis (TRT), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), poses a significant health risk associated with long-haul travel. Prolonged immobility, dehydration, and cabin pressure changes during flights contribute to venous stasis, hypoxia, and hypercoagulability, collectively increasing the risk of venous thromboembolism (VTE). While the absolute risk of TRT is relatively low in the population overall, it rises significantly among high-risk groups, including individuals with a history of VTE, thrombophilia, pregnancy, or recent surgery. This review explores the epidemiology, pathophysiology, clinical presentation, and diagnostic evaluation of TRT while highlighting the importance of early recognition and prevention. Risk assessment models can provide guidance for identifying at-risk travelers. Preventive strategies include pharmacological prophylaxis with low-molecular-weight heparin (LMWH) for high-risk individuals and nonpharmacological measures such as compression stockings, intermittent pneumatic compression, mobility exercises, and hydration. Guidelines from international societies recommend tailored interventions based on individual risk profiles, as randomized controlled trials are scarce. Given that long-haul travel dramatically expands, this review critically analyzes the available TRT management strategies in various clinical settings, aiming to increase awareness of this global health issue.

Keywords

thrombosis - venous thromboembolism - pulmonary embolism - risk factors - risk assessment - prevention strategies


Publication History

Article published online:
27 February 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Kuipers S, Schreijer AJ, Cannegieter SC, Büller HR, Rosendaal FR, Middeldorp S. Travel and venous thrombosis: a systematic review. J Intern Med 2007; 262 (06) 615-634
    CrossrefPubMedSearch in Google Scholar
  • 2 Brill A. Multiple facets of venous thrombosis. Int J Mol Sci 2021; 22 (08) 3853
    CrossrefPubMedSearch in Google Scholar
  • 3 Şabanoğlu C. The secret enemy during a flight: economy class syndrome. Anatol J Cardiol 2021; 25 (Suppl. 01) 13-17
    CrossrefPubMedSearch in Google Scholar
  • 4 Kakkos SK, Geroulakos G. Economy class stroke syndrome: case report and review of the literature. Eur J Vasc Endovasc Surg 2004; 27 (03) 239-243
    CrossrefPubMedSearch in Google Scholar
  • 5 Symington IS, Stack BH. Pulmonary thromboembolism after travel. Br J Dis Chest 1977; 71 (02) 138-140
    CrossrefPubMedSearch in Google Scholar
  • 6 Homans J. Thrombosis of the deep leg veins due to prolonged sitting. N Engl J Med 1954; 250 (04) 148-149
    CrossrefPubMedSearch in Google Scholar
  • 7 Milne R. Venous thromboembolism and travel: is there an association?. J R Coll Physicians Lond 1992; 26 (01) 47-49
    PubMedSearch in Google Scholar
  • 8 Landgraf H, Vanselow B, Schulte-Huermann D, Mülmann MV, Bergau L. Economy class syndrome: rheology, fluid balance, and lower leg edema during a simulated 12-hour long distance flight. Aviat Space Environ Med 1994; 65 (10 Pt 1): 930-935
    PubMedSearch in Google Scholar
  • 9 House of Lords. Science and Technology Committee. Air Travel and Health: an Update. Report and Evidence. The Stationery Office Ltd., London, 2007. Accessed January 2025 at: https://publications.parliament.uk/pa/ld200708/ldselect/ldsctech/7/7.pdf
    PubMed
  • 10 Jacobson BF, Münster M, Smith A. et al. The BEST study–a prospective study to compare business class versus economy class air travel as a cause of thrombosis. S Afr Med J 2003; 93 (07) 522-528
    PubMedSearch in Google Scholar
  • 11 Kuipers S, Venemans A, Middeldorp S, Büller HR, Cannegieter SC, Rosendaal FR. The risk of venous thrombosis after air travel: contribution of clinical risk factors. Br J Haematol 2014; 165 (03) 412-413
    CrossrefPubMedSearch in Google Scholar
  • 12 Chandra D, Parisini E, Mozaffarian D. Meta-analysis: travel and risk for venous thromboembolism. Ann Intern Med 2009; 151 (03) 180-190
    CrossrefPubMedSearch in Google Scholar
  • 13 Kuipers S, Cannegieter SC, Middeldorp S, Robyn L, Büller HR, Rosendaal FR. The absolute risk of venous thrombosis after air travel: a cohort study of 8,755 employees of international organisations. PLoS Med 2007; 4 (09) e290
    CrossrefPubMedSearch in Google Scholar
  • 14 Lapostolle F, Surget V, Borron SW. et al. Severe pulmonary embolism associated with air travel. N Engl J Med 2001; 345 (11) 779-783
    CrossrefPubMedSearch in Google Scholar
  • 15 WHO Research into Global Hazards of Travel (WRIGHT) project: final report of phase I. Final report of phase I. World Health Organization 2007. Accessed January 2025 at: https://iris.who.int/bitstream/handle/10665/43684/9789241595537_eng.pdf?sequence=1&isallowed=y
    PubMed
  • 16 Martinelli I, Taioli E, Battaglioli T. et al. Risk of venous thromboembolism after air travel: interaction with thrombophilia and oral contraceptives. Arch Intern Med 2003; 163 (22) 2771-2774
    CrossrefPubMedSearch in Google Scholar
  • 17 MacCallum PK, Ashby D, Hennessy EM. et al. Cumulative flying time and risk of venous thromboembolism. Br J Haematol 2011; 155 (05) 613-619
    CrossrefPubMedSearch in Google Scholar
  • 18 Arfvidsson B, Eklof B, Kistner RL, Masuda EM, Sato DT. Risk factors for venous thromboembolism following prolonged air travel. Coach class thrombosis. Hematol Oncol Clin North Am 2000; 14 (02) 391-400 , ix
    CrossrefPubMedSearch in Google Scholar
  • 19 Philbrick JT, Shumate R, Siadaty MS, Becker DM. Air travel and venous thromboembolism: a systematic review. J Gen Intern Med 2007; 22 (01) 107-114
    CrossrefPubMedSearch in Google Scholar
  • 20 Tourn J, Crescence L, Bruzzese L, Panicot-Dubois L, Dubois C. Cellular and molecular mechanisms leading to air travel-induced thrombosis. Circ Res 2025; 136 (01) 115-134
    CrossrefPubMedSearch in Google Scholar
  • 21 Schreijer AJ, Cannegieter SC, Meijers JC, Middeldorp S, Büller HR, Rosendaal FR. Activation of coagulation system during air travel: a crossover study. Lancet 2006; 367 (9513): 832-838
    CrossrefPubMedSearch in Google Scholar
  • 22 Piazza G. Beyond Virchow's Triad: does cardiovascular inflammation explain the recurrent nature of venous thromboembolism?. Vasc Med 2015; 20 (02) 102-104
    CrossrefPubMedSearch in Google Scholar
  • 23 Sándor T. Travel thrombosis: pathomechanisms and clinical aspects. Pathophysiology 2008; 15 (04) 243-252
    CrossrefPubMedSearch in Google Scholar
  • 24 Krasiński Z, Chou A, Stępak H. COVID-19, long flights, and deep vein thrombosis: what we know so far. Cardiol J 2021; 28 (06) 941-953
    CrossrefPubMedSearch in Google Scholar
  • 25 Humphreys S, Deyermond R, Bali I, Stevenson M, Fee JP. The effect of high altitude commercial air travel on oxygen saturation. Anaesthesia 2005; 60 (05) 458-460
    CrossrefPubMedSearch in Google Scholar
  • 26 Nagda NL, Hodgson M. Low relative humidity and aircraft cabin air quality. Indoor Air 2001; 11 (03) 200-214
    CrossrefPubMedSearch in Google Scholar
  • 27 Kraus C, Kadriu B, Lanzenberger R, Zarate Jr CA, Kasper S. Prognosis and improved outcomes in major depression: a review. Transl Psychiatry 2019; 9 (01) 127
    CrossrefPubMedSearch in Google Scholar
  • 28 Hoirisch-Clapauch S, Nardi AE, Gris JC, Brenner B. Coagulation and mental disorders. Rambam Maimonides Med J 2014; 5 (04) e0036
    CrossrefPubMedSearch in Google Scholar
  • 29 Austin AW, Wissmann T, von Kanel R. Stress and hemostasis: an update. Semin Thromb Hemost 2013; 39 (08) 902-912
    Thieme ConnectPubMedSearch in Google Scholar
  • 30 Halleux CM, Declerck PJ, Tran SL, Detry R, Brichard SM. Hormonal control of plasminogen activator inhibitor-1 gene expression and production in human adipose tissue: stimulation by glucocorticoids and inhibition by catecholamines. J Clin Endocrinol Metab 1999; 84 (11) 4097-4105
    PubMedSearch in Google Scholar
  • 31 Lang UE, Borgwardt S. Molecular mechanisms of depression: perspectives on new treatment strategies. Cell Physiol Biochem 2013; 31 (06) 761-777
    CrossrefPubMedSearch in Google Scholar
  • 32 Lopez-Vilchez I, Serra-Millas M, Navarro V. et al. Prothrombotic platelet phenotype in major depression: downregulation by antidepressant treatment. J Affect Disord 2014; 159: 39-45
    CrossrefPubMedSearch in Google Scholar
  • 33 Lahlou-Laforet K, Alhenc-Gelas M, Pornin M. et al. Relation of depressive mood to plasminogen activator inhibitor, tissue plasminogen activator, and fibrinogen levels in patients with versus without coronary heart disease. Am J Cardiol 2006; 97 (09) 1287-1291
    CrossrefPubMedSearch in Google Scholar
  • 34 Tsantes AE, Nikolopoulos GK, Bagos PG, Bonovas S, Kopterides P, Vaiopoulos G. The effect of the plasminogen activator inhibitor-1 4G/5G polymorphism on the thrombotic risk. Thromb Res 2008; 122 (06) 736-742
    CrossrefPubMedSearch in Google Scholar
  • 35 McIntosh IB, Swanson V, Power KG, Raeside F, Dempster C. Anxiety and health problems related to air travel. J Travel Med 1998; 5 (04) 198-204
    CrossrefPubMedSearch in Google Scholar
  • 36 Carreira-Míguez M, Navarro-Jiménez E, Clemente-Suárez VJ. Behavioral patterns of depression patients and control population. Int J Environ Res Public Health 2022; 19 (15) 9506
    CrossrefPubMedSearch in Google Scholar
  • 37 Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm (Vienna) 2009; 116 (06) 777-784
    CrossrefPubMedSearch in Google Scholar
  • 38 Penninx BW, Pine DS, Holmes EA, Reif A. Anxiety disorders. Lancet 2021; 397 (10277): 914-927
    CrossrefPubMedSearch in Google Scholar
  • 39 Brenner B. Interventions to prevent venous thrombosis after air travel, are they necessary? Yes. J Thromb Haemost 2006; 4 (11) 2302-2305
    CrossrefPubMedSearch in Google Scholar
  • 40 Mendis S, Yach D, Alwan A. Air travel and venous thromboembolism. Bull World Health Organ 2002; 80 (05) 403-406
    PubMedSearch in Google Scholar
  • 41 Dubois-Silva Á, Barbagelata-López C, Piñeiro-Parga P. et al; RIETE Investigators. Deep vein thrombosis symptoms and 30-day mortality in acute pulmonary embolism. Eur J Intern Med 2023; 108: 43-51
    CrossrefPubMedSearch in Google Scholar
  • 42 Mackman N. New insights into the mechanisms of venous thrombosis. J Clin Invest 2012; 122 (07) 2331-2336
    CrossrefPubMedSearch in Google Scholar
  • 43 Kahn SR, Lim W, Dunn AS. et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (Suppl. 02) e195S-e226S
    CrossrefPubMedSearch in Google Scholar
  • 44 Tovey C, Wyatt S. Diagnosis, investigation, and management of deep vein thrombosis. BMJ 2003; 326 (7400): 1180-1184
    CrossrefPubMedSearch in Google Scholar
  • 45 Huisman MV, Tromeur C, Le Gal G, Le Roux PY, Righini M. Diagnostic management of acute pulmonary embolism. Presse Med 2024; 53 (03) 104241
    CrossrefPubMedSearch in Google Scholar
  • 46 Patel H, Sun H, Hussain AN, Vakde T. Advances in the diagnosis of venous thromboembolism: a literature review. Diagnostics (Basel) 2020; 10 (06) 365
    CrossrefPubMedSearch in Google Scholar
  • 47 Eklöf B, Maksimovic D, Caprini JA, Glase C. Air travel-related venous thromboembolism. Dis Mon 2005; 51 (2-3): 200-207
    CrossrefPubMedSearch in Google Scholar
  • 48 Mercer A, Brown JD. Venous thromboembolism associated with air travel: a report of 33 patients. Aviat Space Environ Med 1998; 69 (02) 154-157
    PubMedSearch in Google Scholar
  • 49 Schobersberger W, Fries D, Mittermayr M. et al. Changes of biochemical markers and functional tests for clot formation during long-haul flights. Thromb Res 2002; 108 (01) 19-24
    CrossrefPubMedSearch in Google Scholar
  • 50 Schreijer AJ, Hoylaerts MF, Meijers JC. et al. Explanations for coagulation activation after air travel. J Thromb Haemost 2010; 8 (05) 971-978
    CrossrefPubMedSearch in Google Scholar
  • 51 Kearon C, Akl EA, Comerota AJ. et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (Suppl. 02) e419S-e496S
    CrossrefPubMedSearch in Google Scholar
  • 52 Seed SM, Khov SL, Binguad FS, Abraham GM, Aungst TD. Identification and review of mobile applications for travel medicine practitioners and patients. J Travel Med 2016; 23 (04) taw034
    PubMedSearch in Google Scholar
  • 53 Ferretti A, Hedrich N, Lovey T, Vayena E, Schlagenhauf P. Mobile apps for travel medicine and ethical considerations: a systematic review. Travel Med Infect Dis 2021; 43: 102143
    CrossrefPubMedSearch in Google Scholar
  • 54 Flaherty GT, Hamer DH, Chen LH. Travel in the time of COVID: a review of international travel health in a global pandemic. Curr Infect Dis Rep 2022; 24 (10) 129-145
    CrossrefPubMedSearch in Google Scholar
  • 55 Coughlin SS, Stewart J. Use of consumer wearable devices to promote physical activity: a review of health intervention studies. J Environ Health Sci 2016;2(06):
    PubMed
  • 56 Hayssen H, Cires-Drouet R, Englum B. et al. Systematic review of venous thromboembolism risk categories derived from Caprini score. J Vasc Surg Venous Lymphat Disord 2022; 10 (06) 1401-1409.e7
    CrossrefPubMedSearch in Google Scholar
  • 57 van Belle A, Büller HR, Huisman MV. et al; Christopher Study Investigators. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 2006; 295 (02) 172-179
    CrossrefPubMedSearch in Google Scholar
  • 58 Wells PS, Anderson DR, Bormanis J. et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet 1997; 350 (9094): 1795-1798
    CrossrefPubMedSearch in Google Scholar
  • 59 Pandor A, Tonkins M, Goodacre S. et al. Risk assessment models for venous thromboembolism in hospitalised adult patients: a systematic review. BMJ Open 2021; 11 (07) e045672
    CrossrefPubMedSearch in Google Scholar
  • 60 McKerrow Johnson I, Shatzel J, Olson S, Kohl T, Hamilton A, DeLoughery TG. Travel-associated venous thromboembolism. Wilderness Environ Med 2022; 33 (02) 169-178
    CrossrefPubMedSearch in Google Scholar
  • 61 Chamnanchanunt S, Rojnuckarin P. Direct oral anticoagulants and travel-related venous thromboembolism. Open Med (Wars) 2018; 13: 575-582
    CrossrefPubMedSearch in Google Scholar
  • 62 Kuipers S, Cannegieter SC, Middeldorp S, Rosendaal FR, Büller HR. Use of preventive measures for air travel-related venous thrombosis in professionals who attend medical conferences. J Thromb Haemost 2006; 4 (11) 2373-2376
    CrossrefPubMedSearch in Google Scholar
  • 63 Kakkos S, Kirkilesis G, Caprini JA. et al. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism. Cochrane Database Syst Rev 2022; 1 (01) CD005258
    PubMedSearch in Google Scholar
  • 64 Olsen JHH, Öberg S, Rosenberg J. The effect of compression stocking on leg edema and discomfort during a 3-hour flight: a randomized controlled trial. Eur J Intern Med 2019; 62: 54-57
    CrossrefPubMedSearch in Google Scholar
  • 65 Clarke MJ, Broderick C, Hopewell S, Juszczak E, Eisinga A. Compression stockings for preventing deep vein thrombosis in airline passengers. Cochrane Database Syst Rev 2021; 4 (04) CD004002
    PubMedSearch in Google Scholar
  • 66 Geerts WH, Bergqvist D, Pineo GF. et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008; 133 (Suppl. 6) 381S-453S
    CrossrefPubMedSearch in Google Scholar
  • 67 Hitos K, Cannon M, Cannon S, Garth S, Fletcher JP. Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel-related deep vein thrombosis. J Thromb Haemost 2007; 5 (09) 1890-1895
    CrossrefPubMedSearch in Google Scholar
  • 68 Powell-Dunford N, Adams JR, Grace C. Medical advice for commercial air travel. Am Fam Physician 2021; 104 (04) 403-410
    PubMedSearch in Google Scholar
  • 69 Couch RD. Travel, time zones, and sudden cardiac death. Emporiatric pathology. Am J Forensic Med Pathol 1990; 11 (02) 106-111
    CrossrefPubMedSearch in Google Scholar
  • 70 Schmitt HE, Mihatsch MJ. Thrombosis of the popliteal vein. Cardiovasc Intervent Radiol 1992; 15 (04) 234-239
    CrossrefPubMedSearch in Google Scholar
  • 71 Teenan RP, McKay AJ. Peripheral arterial thrombosis related to commercial airline flights: another manifestation of the economy class syndrome. Br J Clin Pract 1992; 46 (03) 165-166
    CrossrefPubMedSearch in Google Scholar
  • 72 Kakkos SK, Gohel M, Baekgaard N. et al; Esvs Guidelines Committee. Editor's choice - European Society for Vascular Surgery (ESVS) 2021 clinical practice guidelines on the management of venous thrombosis. Eur J Vasc Endovasc Surg 2021; 61 (01) 9-82
    CrossrefPubMedSearch in Google Scholar
  • 73 Schunemann HJ, Cushman M, Burnett AE. et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv 2023; 7 (09) 1671
    PubMedSearch in Google Scholar
  • 74 Thrombosis Canada. 2023 Air Travel-Related Thrombosis – Guidelines. Accessed January 2025 at: https://thrombosiscanada.ca/clinical_guides/pdfs/91_20.pdf
    PubMed
  • 75 Watson HG, Baglin TP. Guidelines on travel-related venous thrombosis. Br J Haematol 2011; 152 (01) 31-34
    CrossrefPubMedSearch in Google Scholar
  • 76 Riat R. Addendum to Guidelines on travel-related venous thrombosis. Accessed January 2025 at: https://b-s-h.org.uk/media/exvd4gap/2023-11-15-bsh-addendum1-travel-related-thrombosis.pdf
    PubMed
  • 77 ACOG Committee Opinion No. ACOG committee opinion no. 746 summary: air travel during pregnancy. Obstet Gynecol 2018; 132 (02) 533-534
    CrossrefPubMedSearch in Google Scholar
  • 78 Ali MAM, Spinler SA. COVID-19 and thrombosis: from bench to bedside. Trends Cardiovasc Med 2021; 31 (03) 143-160
    CrossrefPubMedSearch in Google Scholar
  • 79 Brito-Dellan N, Tsoukalas N, Font C. Thrombosis, cancer, and COVID-19. Support Care Cancer 2022; 30 (10) 8491-8500
    CrossrefPubMedSearch in Google Scholar
  • 80 Scutelnic A, van de Munckhof A, Miraclin AT. et al. Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19. Eur Stroke J 2024; 9 (03) 676-686
    CrossrefPubMedSearch in Google Scholar
  • 81 Oldenburg J, Klamroth R, Langer F. et al. Diagnosis and management of vaccine-related thrombosis following AstraZeneca COVID-19 vaccination: guidance statement from the GTH. Hamostaseologie 2021; 41 (03) 184-189
    Thieme ConnectPubMedSearch in Google Scholar
  • 82 Iba T, Levy JH. Thrombosis and thrombocytopenia in COVID-19 and after COVID-19 vaccination. Trends Cardiovasc Med 2022; 32 (05) 249-256
    CrossrefPubMedSearch in Google Scholar
  • 83 Lippi G, Favaloro EJ. Cerebral venous thrombosis developing after COVID-19 vaccination: VITT, VATT, TTS, and more. Semin Thromb Hemost 2022; 48 (01) 8-14
    Thieme ConnectPubMedSearch in Google Scholar
  • 84 Izadi M, Alemzadeh-Ansari MJ, Kazemisaleh D, Moshkani-Farahani M, Shafiee A. Do pregnant women have a higher risk for venous thromboembolism following air travel?. Adv Biomed Res 2015; 4: 60
    CrossrefPubMedSearch in Google Scholar
  • 85 Ram S, Shalev-Ram H, Neuhof B. et al. Air travel during pregnancy and the risk of venous thrombosis. Am J Obstet Gynecol MFM 2023; 5 (01) 100751
    CrossrefPubMedSearch in Google Scholar
  • 86 Hillen HF. Thrombosis in cancer patients. Ann Oncol 2000; 11 (Suppl. 03) 273-276
    CrossrefPubMedSearch in Google Scholar
  • 87 Wang R, Tang LV, Hu Y. Genetic factors, risk prediction and AI application of thrombotic diseases. Exp Hematol Oncol 2024; 13 (01) 89
    CrossrefPubMedSearch in Google Scholar
  • 88 Harbsmeier AN, Altintas I, Iversen K, Andersen O, Nehlin JO. Biomarkers and the post-thrombotic syndrome: a systematic review of biomarkers associated with the occurrence of the post-thrombotic syndrome after lower extremity deep venous thrombosis. Phlebology 2023; 38 (09) 577-598
    CrossrefPubMedSearch in Google Scholar
  • 89 Cross B, Turner RM, Zhang JE, Pirmohamed M. Being precise with anticoagulation to reduce adverse drug reactions: are we there yet?. Pharmacogenomics J 2024; 24 (02) 7
    CrossrefPubMedSearch in Google Scholar
  • 90 Ding J, Yue X, Tian X, Liao Z, Meng R, Zou M. Association between inflammatory biomarkers and venous thromboembolism: a systematic review and meta-analysis. Thromb J 2023; 21 (01) 82
    CrossrefPubMedSearch in Google Scholar
  • 91 Bannoud MA, Martins TD, Montalvão SAL, Annichino-Bizzacchi JM, Filho RM, Maciel MRW. Integrating biomarkers for hemostatic disorders into computational models of blood clot formation: a systematic review. Math Biosci Eng 2024; 21 (12) 7707-7739
    CrossrefPubMedSearch in Google Scholar
  • 92 Wikan VE, Tøndel BG, Morelli VM, Brodin EE, Brækkan SK, Hansen JB. Diagnostic blood biomarkers for acute pulmonary embolism: a systematic review. Diagnostics (Basel) 2023; 13 (13) 2301
    CrossrefPubMedSearch in Google Scholar
  • 93 Radanliev P, De Roure D, Walton R. et al. COVID-19 what have we learned? The rise of social machines and connected devices in pandemic management following the concepts of predictive, preventive and personalized medicine. EPMA J 2020; 11 (03) 311-332
    CrossrefPubMedSearch in Google Scholar
  • 94 Shah N, Costello K, Mehta A, Kumar D. Applications of digital health technologies in knee osteoarthritis: narrative review. JMIR Rehabil Assist Technol 2022; 9 (02) e33489
    CrossrefPubMedSearch in Google Scholar
  • 95 Cannard C, Brandmeyer T, Wahbeh H, Delorme A. Self-health monitoring and wearable neurotechnologies. Handb Clin Neurol 2020; 168: 207-232
    CrossrefPubMedSearch in Google Scholar
  • 96 Shaffer F, Meehan ZM. A practical guide to resonance frequency assessment for heart rate variability biofeedback. Front Neurosci 2020; 14: 570400
    CrossrefPubMedSearch in Google Scholar