Thrombolytic therapy can have serious complications in certain clinical conditions. When these conditions occur, thrombolytic therapy should either not be used or else used only with extreme caution.
Complications of thrombolytic therapy:
(1) hemorrhage, including intracerebral hemorrhage
(2) embolic phenomenon from dissolved thrombotic material
(3) anaphylactic response to thrombolytic agent used
Contraindication
Condition
absolute
active internal bleeding
cerebrovascular accident (CVA) or other active intracranial process within past 2 months
history of anaphylaxis to thrombolytic agent used
relative major
major surgery within past 10 days
recent obstetric delivery
recent organ biopsy
recent puncture of noncompressible blood vessel
recent serious gastrointestinal bleeding
recent serious trauma
severe hypertension (systolic blood pressure > 200 mm Hg; diastolic blood pressure > 110 mm Hg)
relative minor
recent minor trauma (including CPR)
high likelihood of thrombus in left heart
bacterial endocarditis
diabetic hemorrhagic retinopathy
pregnancy
age > 75 years
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