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Research letter
Flight-related complications are infrequent in patients with hereditary haemorrhagic telangiectasia/pulmonary arteriovenous malformations, despite low oxygen saturations and anaemia
  1. Christopher G Mason1,
  2. Claire L Shovlin1,2
  1. 1Department of Respiratory Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
  2. 2NHLI Cardiovascular Sciences, Imperial College, Hammersmith Campus, London, UK
  1. Correspondence to Dr Claire L Shovlin, Senior Lecturer, and Honorary Consultant in Respiratory Medicine, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK; c.shovlin{at}


Individuals with pulmonary arteriovenous malformations (PAVMs) and hereditary haemorrhagic telangiectasia (HHT) commonly have low oxygen saturations and anaemia, two parameters generally used to indicate medical fitness to fly. Using a retrospective questionnaire-based study, the authors examined in-flight complications and predictors in 145 HHT patients (96 with PAVMs) who reported 3950 flights, totalling 18 943 flight hours. Dyspnoea and thrombotic complications were less common than expected, and could not be predicted from sea level oxygen saturations or haemoglobin concentrations. Nosebleeds that can bar individuals from boarding a flight occurred in 13.6% (11.5% to 15.8%) of long-haul flights. The findings should influence preflight advice.

  • Hypoxaemia
  • nosebleeds
  • oxygen
  • stroke
  • thrombosis
  • pulmonary embolism
  • rare lung diseases
  • asthma
  • bronchiectasis
  • COPD pharmacology
  • cystic fibrosis

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  • Both authors had full access to all of the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This work was performed as part of an NIHR Academic FY2 post (CGM). CLS is also grateful for support from the Imperial NIHR Biomedical Research Centre Funding Scheme. The funders had no part in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

  • Competing interests None.

  • Ethics approval Ethical approval was obtained from the London-Surrey Borders Research Ethics Committee (NRES 10/H0806/8).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors are fully committed to the principles of data sharing.