When is surgery contraindicated for the treatment of phlegmasia alba dolens (PAD) and phlegmasia cerulea dolens (PCD)?

Updated: Aug 13, 2018
  • Author: Cassius Iyad Ochoa Chaar, MD, MS, FACS; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Catheter-directed thrombolysis is contraindicated in certain patients. [17] Absolute contraindications include the folowing:

  • Active bleeding
  • Recent neurologic surgery (cranial or spinal)
  • Trauma or cerebrovascular accident less than 2 months previously
  • Brain tumor
  • Severe hypertension
  • Coagulopathy
  • Allergy to thrombolytic agents

Relative contraindications include the following:

  • Surgery less than 10 days previously
  • Recent trauma or gastrointestinal hemorrhage
  • Subacute bacterial endocarditis
  • Severe liver or kidney disease
  • Pancreatitis
  • Pregnancy
  • Any other scenario in which there seems to be a risk of hemorrhage that might be either excessive or difficult to control

Endovascular iliocaval reconstruction has been described for the treatment of iliocaval thrombosis. [18]


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