[Markus Peck-Radosavljevic]

Dear Audrey,
I think there is enough evidence to show that anticoagulation is safe in patients with thrombocytopenia and liver disease (mostly cirrhosis but I do not see why this should be different in your patient).
We would continue her on anticoagulation, either warfarin, LMWH, or DOAK’s (here you should not be too aggressive with the dose). I would not worry about bleeding complications, even if she would have varices. My main concern also would be the risk to develop progressive thrombosis of the splanchnic venous bed.
Kind regards,
Markus

[Markus Peck-Radosavljevic]

I am not sure about the ”twisting“ but we had similar cases of IVC-stenosis and were able to treat them successfully with stenting.
So, I personally would stent this patient.

Kind regards,

Markus Peck

Prof. Dr. Markus Peck-Radosavljevic, M.D.

Chair, Dept. Internal Medicine & Gastroenterology (IMuG)
Hepatology, Endocrinology, Rheumatology and Nephrology
with Centralized Emergency Department (ZAE)

Klinikum Klagenfurt am Wörthersee
Feschnigstrasse 11
9020 Klagenfurt
Austria

Ph: +43 463 538 31103 (Ms. Werkl)
Fax: +43 463 538 31109

On Twitter: @MarkusPeck1

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