What are the contraindications for percutaneous transcatheter treatment for deep venous thrombosis (DVT)?

Updated: Dec 10, 2019
  • Author: Donald Schreiber, MD, CM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Contraindications for percutaneous transcatheter treatment are the same as those for thrombolysis in general. Absolute contraindications include active internal bleeding or disseminated intravascular coagulation, a cerebrovascular event, trauma, and neurosurgery within 3 months.

Relative contraindications include major surgery within 10 days, obstetric delivery, major trauma, organ biopsy, intracranial or spinal cord tumor, uncontrolled hypertension, major GI hemorrhage (within 3 months), serious allergic reaction to a thrombolytic agent, known right-to-left cardiac or pulmonary shunt or left-heart thrombus, and an infected venous thrombus. Unfortunately, most patients with DVT have absolute contraindications to thrombolytic therapy.

Thrombolytic therapy is also not effective once the thrombus is adherent and begins to organize. Venous thrombi in the legs are often large and associated with complete venous occlusion. In these cases, thrombolytic agents act on the surface of the clot but may not be able to penetrate and lyse the entire thrombus.


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