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Table 4 Contraindications to anticoagulation treatment

From: Venous thromboembolism in cancer patients: an underestimated major health problem

  Contraindications
Absolute contraindications Active major, serious, or potentially life-threatening bleeding not reversible with medical or surgical intervention, including but not limited to any active bleeding in a critical site (i.e., intracranial, pericardial, retroperitoneal, intraocular, intra-articular, intraspinal) [10-12a]
-Active bleeding (major): more than 2 units transfused in 24 h, chronic [11,12a]
-Severe, uncontrolled malignant hypertension [10,12a]
-Severe, uncompensated coagulopathy (e.g., liver failure) [10]
-Severe platelet dysfunction or inherited bleeding disorder [10-12a]
-Persistent, severe thrombocytopenia (20,000/L) [10]
-Surgery or invasive procedure, including but not limited to lumbar puncture, spinal anesthesia, and epidural catheter placement [10-12a]
Relative contraindications -Intracranial or spinal lesion at high risk for bleeding [10-12]
-Active peptic or other GI ulceration at high risk of bleeding [10,12]
-Active but non-life-threatening bleeding (e.g., trace hematuria) [10]
-Intracranial or CNS bleeding within past 4 weeks [10]
-Major surgery or serious bleeding within past 2 weeks [10-12]
-Persistent thrombocytopenia (50,000/L) [10-12]
-Chronic, clinically significant measurable bleeding >48 h [11]
-High risk for falls (head trauma) [11]
  1. aFor ESMO guidelines, all the contraindications are referred as relative