Hypercholesterolemia refractory to conventional therapy
Unselective plasma exchange as a precursor of LDL apheresis (before 1980)
Development of selective LDL-apheresis methods (1981–1993)
Year of introduction | Procedure | Principle | LDL-reduction (%) | Reference |
---|---|---|---|---|
1966 | Plasmapheresis | LDL-elimination by plasma exchange | [7] | |
1980 | Heparin-adsorption | LDL-adsorption (Plasma) | [21] | |
1981 | Immunoadsorption | LDL-adsorption (Plasma) | 35–56 | [41] |
1983 | Differential filtration | LDL-filtration (Plasma) | 56–62 | [51] |
1984 | Dextran sulfate adsorption | LDL-adsorption (Plasma) | 49–75 | [55] |
1985 | Thermofiltration | LDL-filtration (Plasma) | 61 | [26] |
1986 | Heparin-induced extracorporeal LDL-precipitation (H.E.L.P.) | LDL-precipitation (Plasma) | 55–61 | [3] |
1992 | Direct adsorption of lipids (DALI) | LDL-adsorption (whole blood) | 53–76 | [5] |
Effectiveness and sustainability of LDL-cholesterol lowering by LDL apheresis
Clinical efficacy of LDL apheresis
Case studies (from 1967 onward)
Regression studies (1992–1999)
Study (reference) | Apheresis patients (n) | Reduction of LDL-cholesterol (%) | Quantitative angiography (segment-based analysis; %) | ||
---|---|---|---|---|---|
NC | R | P | |||
HELP [36] | 51 | 62 | 55 | 30 | 15 |
LARS [43] | 37 | 55 | 49 | 38 | 13 |
GM [52] | 25 | 58 | 64 | < 1 | 36 |
FHRS [49] | 20 | 53 | 65 | 25 | 10 |
LAARS [19] | 20 | 63 | 45 | 10 | 45 |
163 | 53–74 | 45–64 | 0–38 | 10–45 |