Why should pharmacologic revascularization be avoided in certain patients?

Pharmacologic revascularization, which typically involves the use of thrombolytics to dissolve clots, can pose significant risks in patients with a history of prior intracranial hemorrhage. This is particularly important because the administration of thrombolytics can increase the likelihood of another hemorrhagic event, potentially leading to severe complications such as permanent neurological deficits or even death. The risk of bleeding complications, especially in patients with a history of intracranial hemorrhage, outweighs the potential benefits of revascularization in these cases.

The other conditions listed, while they may warrant cautious consideration or alternative approaches, do not inherently contraindicate the use of pharmacologic revascularization. For instance, having had a previous myocardial infarction does not automatically exclude a patient from receiving thrombolytics, as the therapy can be beneficial in the setting of acute coronary syndrome. Similarly, stable angina and aortic regurgitation are not considered absolute contraindications to pharmacologic revascularization, although other therapeutic strategies may be more appropriate based on the specific clinical scenario.