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Contraindications to fibrinolysis for peripheral artery occlusion

Contraindications to fibrinolysis for peripheral artery occlusion
Major contraindications
 Established cerebrovascular event (including recent TIAs)
 Bleeding diathesis
 Recent gastrointestinal bleeding (<10 days)
 Recent (within 3 months) neurosurgery (intracranial, spinal)
 Recent intracranial trauma
Relative major contraindications
 Recent cardiopulmonary resuscitation
 Recent major nonvascular surgery or trauma
 Uncontrolled hypertension: >180 mmHg systolic, >110 mmHg diastolic
 Puncture of non-compressible vessel
 Intracranial tumor
 Recent eye surgery
 Others*
The list above gives the contraindications to fibrinolysis for peripheral arterial occlusion. Decision-making must be individualized, weighing the benefits of thrombolysis with the risk of bleeding.
TIA: transient ischemic attack. 
* Other relative minor contraindications include hepatic failure, particularly with coagulopathy; bacterial endocarditis; pregnancy; and diabetic hemorrhagic retinopathy.
References: 
  1. Working Party on Thrombolysis in the Management of Limb Ischemia. Thrombolysis in the management of lower limb peripheral arterial occlusion--a consensus document. J Vasc Interv Radiol 2003; 14:S337.
  2. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141:e419S.
  3. Manufacturer instructions for use; label for Cathflo Activase. United States Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/103172s5203lbl.pdf. Accessed June 8, 2018.
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