What are absolute contraindications for thrombolysis?

The identification of contraindications for thrombolysis is crucial because it involves the dissolution of blood clots, which carries specific risks, particularly of bleeding. Absolute contraindications indicate scenarios where the procedure should not be performed under any circumstances due to significant potential harm.

A history of brain neoplasm is an absolute contraindication because it puts the patient at a significantly increased risk of hemorrhagic complications. In patients with pre-existing tumors in the brain, any additional disruption to the vascular integrity of that area due to thrombolysis can lead to catastrophic hemorrhage. The presence of a neoplasm may also complicate existing blood-brain barrier integrity, further increasing the danger of bleed complications that can occur during or after the administration of thrombolytic agents.

In contrast, uncontrolled hypertension, recent surgery within the past 10 days, and bleeding disorders, while serious considerations that require careful evaluation and may lead to relative contraindications, are not classified as absolute contraindications in all cases. These conditions might warrant individual assessment to determine the suitability for thrombolysis rather than outright prohibition.