Although the PREPIC 2 study has improved the quality of evidence for this recommendation, overall quality is still moderate because of imprecision (Table 16, e-Table 16). The AT10 panel decided against combining the results of TABLE 15 ] Risk Factors for Bleeding With, and Contraindications to Use of, Thrombolytic Therapy (Both Systemic and Locally Administered) Major Contraindicationsa Structural intracranial disease Previous intracranial hemorrhage Ischemic stroke within 3 mo Active bleeding Recent brain or spinal surgery Recent head trauma with fracture or brain injury Bleeding diathesis Relative contraindicationsb Systolic BP >180 Diastolic BP >110 Recent bleeding (nonintracranial) Recent surgery Recent invasive procedure Ischemic stroke more than 3 mo previously Anticoagulated (eg, VKA therapy) Traumatic cardiopulmonary resuscitation Pericarditis or pericardial uid Diabetic retinopathy Pregnancy Age >75 y Low body weight (eg, <60 kg) Female Black race See Table 1 and 6 legends for expansion of abbreviations and GRADE Working Group grades of evidence. a The presence of major contraindications usually precludes use of thrombolytic therapy; consequently, these factors have not been well studied as risk factors for bleeding associated with thrombolytic therapy. Patients with 1 or more major contraindication are usually considered to be high risk for bleeding with thrombolytic therapy. The factors listed in this table are consistent with other recommendations for the use of thrombolytic therapy in patients with PE.138,233-235 b Risk factors for bleeding during anticoagulant therapy that are noted in Table 11 that are not included in this table are also likely to be relative contraindications to thrombolytic therapy. The increase in bleeding associ- atedwith a risk factor will vary with:(1) severity of the risk factor (eg, extent of trauma or recent surgery) and (2) temporal relationships (eg, interval from surgery or a previous bleeding episode; believed to decrease markedly after approximately 2 wk). 