For any radiology procedure there are contraindications which serve as a guideline as to why the procedure in question should not be done. The contraindications are often specific to the procedure in question, however there are some elements of procedural radiology contraindications that are more universal and will be covered on this page.
CATEGORIES OF CONTRAINDICATIONS
There are a few different types of contraindications that are commonly thought about in procedural radiology (as well as other procedural specialties).
- Absolute contraindications: these are contraindications that if present, mandate that a procedure can not be performed. Other clinical information generally does not influence the decisions making process when an absolute contraindication is present.
- Relative contraindications: these are contraindications that if present, may or many not prevent the procedure from occurring. Other clinical information will factor into this decision. Generally a proceduralist will avoid performing a procedure on a patient with relative contraindications. With this in mind, in certain cases it may be in the best of the interest to still perform the procedure.
While of course contraindications generally are influenced by the procedure in question, there are a few universal absolute contraindications that can be applied broadly:
- Unstable patients: in most cases (unless the radiology procedure is the only way to stabilize the patient) patients who are medically unstable (such as hemodynamically unstable) will not be safe to transport to, and undergo a radiology procedure.
- Patients with disseminated intravascular coagulation (DIC): in this setting it can be too dangerous to puncture the patient anywhere.
While of course contraindications generally are influenced by the procedure in question, there are a few universal relative contraindications that can be applied broadly:
- Coagulopathies (lab values): classically a INR greater then 1.5 and platelet counts less then 50,000 per cubic millimeter serve as relative contraindications to performing a a variety of radiology procedures given the risk of bleeding. In some cases more liberal transfusion thresholds are used (INR < 2.5, platelets > 30,000), are used, and more recently there are new anticoagulation guidelines that are less stringent regarding lab values.
- Infection (especially if it involves an area that will be accessed for the procedure): for a variety of cases infection (either systemic, or focal) may serve as a contraindication to performing a variety of radiology procedures.
Page Updated: 12.21.19