Do you maintain a strict platelet threshold of >50k when performing a lumbar puncture, or are there situations in which you feel comfortable with a lower threshold?

Our institution still uses 50k as a best practice guideline, though many of our proceduralists are comfortable performing the procedure with platelets slightly lower than 50k, and will have a risk/benefit discussion with the patient/team about the bleeding risk prior to proceeding; I myself would be comfortable with performing the procedure with platelets >40k without any intervention, and if lower and very necessary, will often recommend a platelet transfusion during the procedure. The more data that comes out (especially in the BMT literature), the more comfortable I will likely become in the future performing the procedure at even lower platelet counts. The Society of Interventional Radiology (not my society, I am a hospitalist, but I ge...