What is a safe platelet count to perform arterial puncture?
A platelet count of less than 50,000 should raise concern about significant bleeding after any puncture, arterial or venous. Platelet counts of less than 20,000 could be considered as an absolute contraindication for punctures. In some patients, especially those with renal failure, even platelet counts around 100,000 might be associated with some bleeding due to renal failure-related platelet dysfunction. We should understand the cause of low platelets before any invasive procedure. Although we may get through the cath without problems, the post-cath care may be complicated by significant bleeding, especially at the arterial puncture site. We should also be concerned about bleeding if an intervention, pacemaker insertion, intra-aortic balloon pump (IABP), or significant intracardiac catheter manipulations which might bruise or even puncture heart structures have been performed. Some maneuvers (e.g., a transseptal approach) are obviously associated with a high risk for bleeding even whe
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