Treatment of Arteriosclerotic Obstruction by LDL Adsorption

Abstract

According to the authors' clinical analysis, about half of the patients who suffer from arteriosclerotic obstruction (ASO) in the lower extremity(-ies) with clinical manifestation are dyslipidemic (total cholesterol ≥ 220 mg/dL or LDL cholesterol ≥140 mg/dL). As suggested by clinical success in regression of ASO in the coronary arteries as a result of aggressive removal of LDL, LDL adsorp tion utilizing an extracorporeal circulation technique with a dextran sulfate/cel lulose adsorbent column was applied in 33 patients (22 men and 11 women) with ASO. Clinical results obtained after a series of 10 LDL adsorption procedures as a standard showed encouraging success. Improvement in subjective symp toms was achieved as follows: 88.5% for cold lower extremity, 87.1% for inter mittent claudication, 53.8% for leg/toe pain at rest, and 60% for disappearance/ size diminution of ulcer/necrosis. Improvements in objective examination find ings supported subjective ones: 85.7% by plethysmography, 81% by thermogra phy and 70% by ankle pressure index. No serious complications or untoward ef fects were observed during or after the adsorption procedures. In conclusion, LDL adsorption appears to be a useful and safe tool in treatment of ASO pa tients with dyslipidemia.