Cirrhotic patients with severe thrombocytopenia are at increased risk of bleeding during invasive procedures.The need for preprocedural prophylaxis aimed at reducing the risk of bleeding in cirrhotic patients with thr...Cirrhotic patients with severe thrombocytopenia are at increased risk of bleeding during invasive procedures.The need for preprocedural prophylaxis aimed at reducing the risk of bleeding in cirrhotic patients with thrombocytopenia who undergo scheduled procedures is assessed via the platelet count;however,establishing a minimum threshold considered safe is challenging.A platelet count≥50000/μL is a frequent target,but levels vary by provider,procedure,and specific patient.Over the years,this value has changed several times according to the different guidelines proposed in the literature.According to the latest guidelines,many procedures can be performed at any level of platelet count,which should not necessarily be checked before the procedure.In this review,we aim to investigate and describe how the guidelines have evolved in recent years in the evaluation of the minimum platelet count threshold required to perform different invasive procedures,according to their bleeding risk.展开更多
Introduction Severe thrombocytopenia(platelet count<50×10^(9)/L)occurs in 1%–2%of patients with liver cirrhosis and is associated with an increased risk of bleeding[1].In this clinical setting,there is no def...Introduction Severe thrombocytopenia(platelet count<50×10^(9)/L)occurs in 1%–2%of patients with liver cirrhosis and is associated with an increased risk of bleeding[1].In this clinical setting,there is no definite agreement on the platelet cut-off below which bleeding risk increases.However,in vitro evidence indicates that thrombin generation is preserved in patients with cirrhosis and platelet counts of>56×10^(9)/L[2].Observational studies found that severe thrombocytopenia may be predictive of post-procedure bleeding after liver biopsy,dental extractions,percutaneous ablation of liver tumors,and endoscopic polypectomy[3].展开更多
文摘Cirrhotic patients with severe thrombocytopenia are at increased risk of bleeding during invasive procedures.The need for preprocedural prophylaxis aimed at reducing the risk of bleeding in cirrhotic patients with thrombocytopenia who undergo scheduled procedures is assessed via the platelet count;however,establishing a minimum threshold considered safe is challenging.A platelet count≥50000/μL is a frequent target,but levels vary by provider,procedure,and specific patient.Over the years,this value has changed several times according to the different guidelines proposed in the literature.According to the latest guidelines,many procedures can be performed at any level of platelet count,which should not necessarily be checked before the procedure.In this review,we aim to investigate and describe how the guidelines have evolved in recent years in the evaluation of the minimum platelet count threshold required to perform different invasive procedures,according to their bleeding risk.
文摘Introduction Severe thrombocytopenia(platelet count<50×10^(9)/L)occurs in 1%–2%of patients with liver cirrhosis and is associated with an increased risk of bleeding[1].In this clinical setting,there is no definite agreement on the platelet cut-off below which bleeding risk increases.However,in vitro evidence indicates that thrombin generation is preserved in patients with cirrhosis and platelet counts of>56×10^(9)/L[2].Observational studies found that severe thrombocytopenia may be predictive of post-procedure bleeding after liver biopsy,dental extractions,percutaneous ablation of liver tumors,and endoscopic polypectomy[3].
