Current Applications > Patient Qualifications
Overviews
Low-Density Lipoprotein Apheresis in the Treatment of Atherosclerosis and Other Potential Uses
Moriarty PM, Gibson CA.
Curr Atheroscler Rep. 2001;3:156-162.

Incorporation of Low-Density Lipoprotein Apheresis into the Treatment Program of Patients With Severe Hypercholesterolemia
Gordon BR.
Curr Atheroscler Rep. 2000;2:308-313.

Effect of HELP-LDL-Apheresis on Outcomes in Patients With Advanced Coronary Atherosclerosis and Severe Hypercholesterolemia
Park J-W, Merz M, Braun P.
Atherosclerosis. 1998;139:401-409.


Long-Term Effect of Low-Density Lipoprotein Apheresis on Plasma Lipoproteins and Coronary Heart Disease in Native Vessels and Coronary Bypass in Severe Heterozygous Familial Hypercholesterolemia
Richter WO, Donner MG, Höfling B, Schwandt P.
Metabolism. 1998;47:863-868.

Safety and Effectiveness of Long-Term LDL-Apheresis in Patients at High Risk
Thiery J, Seidel D.
Curr Opinion Lipidol. 1998;9:521-526.

Abstracts
Activity of Thrombocytes as a Marker of Sufficient Intensity of LDL-Apheresis in Familial Hypercholesterolemia
Blaha M, Pecka M, Urbankova J, et al.
Transfus Apheresis Sci. 2004;30:83-87.
The use of extracorporal elimination for selective removal of LDL-C in severe familial hypercholesterolemia is the treatment of choice. Still, there are no suitable markers for selective elimination of LDL-C, which would reliably determine the therapy intensity immediately after the procedure. A report states that platelet aggregability may be a marker, but this was unsuccessfully tested. As a result, the methods were modified and changes were determined.
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State of the Art of Low-density Lipoprotein Apheresis in the Year 2003
Bosch T, Wendler T.
Ther Apher Dial. 2004;8:76-79.
LDL-apheresis is a last resort treatment for hypercholesterolemic patients resistant to conservative lipid-lowering therapy. In the extracorporeal circuit, LDL, Lp(a) and coagulation factors are selectively eliminated, while the beneficial proteins like HDL, albumin, and immunoglobulins are returned to the patient. Recent studies indicate a positive effect of LDL-apheresis on CHD, carotid artery stenoses, and peripheral vascular disease.
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The HELP System for the Treatment of Atherothrombotic Disorders: A Review
Jaeger BR.
Ther Apher Dial. 2003;7:391-396.
This review underscores recent developments in chronic and single application of apheresis in cardiology with specific emphasis on potential applications, including myocardial infarction, stroke, and following coronary artery bypass grafting.
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The Effects of Three Different LDL-Apheresis Methods on the Plasma Concentrations of E-Selectin, VCAM-1, and ICAM-1
Empen K, Otto C, Brodl UC, Parhofer KG.
J Clin Apheresis. 2002;17:38-43.
In this comparison of three common LDL-apheresis techniques—direct absorption, dextran sulfate adsorption, and heparin precipitation—the authors found the techniques to lower concentrations of the adhesion molecules E-selectin, VCAM-1, and ICAM-1.
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Long-Term Prevention of Premature Coronary Atherosclerosis in Homozygous Familial Hypercholesterolemia
Jaeger BR, Tsobanelis T, Bengel F, Schwaiger S, Seidel D.
J Pediatr. 2002;141:125-128.
This case study of a 22-year-old woman with homozygous familial hypercholesterolemia demonstrates the safety and efficacy of combined statins and LDL-apheresis using the heparin-induced method.
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Intravascular Ultrasound Evaluation of Coronary Plaque Regression by Low Density Lipoprotein-Apheresis Familial Hypercholesterolemia: the Low Density Lipoprotein-Apheresis Coronary Morphology and Reserve Trial (LACMART)
Matsuzaki M, Hiramori K, Imaizumi T, et al.
J Am Coll Cardiol. 2002;40:228-230.
This trial assessed the effects of LDL-apheresis for regression of coronary plaque in familial hypercholesterolemia using coronary angiography and intravascular ultrasound. The group that received medication and LDL-apheresis showed 28.4% reduction in total cholesterol, whereas the group that received medication showed no changes in cholesterol levels.
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Evidence for Maximal Treatment of Atherosclerosis: Drastic Reduction of Cholesterol and Fibrinogen Restores Vascular Homeostasis
Jaeger BR.
Ther Apher. 2001;5:207-211.
This article summarized the clinical and biochemical evidence for maximal treatment of atherosclerosis by a simultaneous 60% to 70% reduction of plasma LDL cholesterol, fibrinogen, and lipoprotein a (LPa) concentrations with statins and LDL-apheresis using the heparin-induced method. Potential future applications are also discussed.
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C-Reactive Protein and Other Markers of Inflammation Among Patients Undergoing HELP LDL Apheresis
Moriarty PM, Gibson CA, Shih J, Matia MS.
Atherosclerosis. 2001;158:495-498.
This trial of familial hypercholesterolemic patients treated with LDL-apheresis therapy using the heparin-induced method evaluates the short- and long-term effects on C-reactive protein (CRP). After 6 months of therapy, pretreatment hsCRP showed an overall mean level decrease of 49%, suggesting that LDL-apheresis rapidly decreases serum hsCRP levels in the long term.
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The Role of LDL Apheresis in Lipid Lowering Therapy for Hyperlipidemic Patients
Lane DM, Bricker LA, Schuff-Werner P.
Current Opinion in Cardiovascular, Pulmonary & Renal Investigational Drugs . 2000;2:216-222.
This review determines that the addition of LDL-apheresis to lipid-lowering drug therapy in hyperlipidemic patients can reduce pretreatment levels and produce lower between-treatment levels of LDL cholesterol than lipid-lowering drug therapy alone.
Full abstract not available.
Heparin-Mediated Extracorporeal LDL/Fibrinogen Precipitation—HELP—in Coronary and Cerebral Ischemia
Jaeger BR, Marx P, Pfefferkorn T, Hamann G, Seidel D.
Acta Neurochir Suppl. 1999;73:81-84.
LDL-apheresis using the heparin-induced method is beneficial in the prevention and therapy of myocardial infarction. This method is now studied in patients with cerebral infarction. The heparin-induced method was found to be safe in patients with coronary heart disease and allows controlled reduction of thrombogenic plasma compounds.
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Coronary Risk Factor Management for the Prevention and Treatment of Graft Vessel Disease in Heart Transplant Patients
Jaeger BR, Schirmer J, Thiery J, et al.
Ther Apher. 1999;3:214-218.
The authors studied whether heart transplant patients could benefit from a combined treatment of statins and LDL-apheresis using the heparin-induced method. Results suggest that early and drastic reduction of the main coronary risk factors may help to prevent retransplantation in high-risk patients.
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Therapeutic Effects of LDL Apheresis in the Prevention of Atherosclerosis
Kajinami K, Mabuchi H.
Curr Opin Lipidol. 1999;10:401-406.
The efficacy and safety of LDL-apheresis has already been established for lipid lowering in patients with refractory hypercholesterolemia. Two reports described excellent long-term follow-up results for patient with coronary artery disease who had been treated with LDL-apheresis using dextran sulfate cellulose columns plus lipid-lowering therapy.
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Long-term Efficacy of Low-Density Lipoprotein Apheresis on Coronary Heart Disease in Familial Hypercholesterolemia
Mabuchi H, Koizumi J, Shimizu M, et al, for the Hokuriku-FH-LDL-Apheresis Study Group.
Am J Cardiol. 1998;82:1489-1495.
This study describes the 6-year safety and efficacy of intensive cholesterol-lowering therapies with LDL-apheresis in heterozygous FH patients with CHD. Patients were treated with lipid-lowering drugs alone or with combined drug therapy and LDL-apheresis. Both treatment groups had significant reduction in cholesterol levels.
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LDL Hemoperfusion—A New Procedure for LDL Apheresis: Biocompatibility Results from a First Pilot Study in Hypercholesterolemic Atherosclerosis Patients
Bosch T, Schmidt B, Kleophas W, Otto V, Samtleben W.
Artif Organs. 1997;21:1060-1065.
A new lipid absorber technology absorbs LDL and lipoprotein (a) directly from the whole blood. Within the scope of a first pilot study, this new procedure combined the features of excellent clinical tolerance, good biocompatibility, and ease of handling.
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Aggressive Lowering of Fibrinogen and Cholesterol in the Prevention of Graft Vessel Disease After Heart Transplantation
Jaeger BR, Meiser B, Nagel D, et al.
Circulation. 1997;96(suppl 9):II-157-II-158.
Combination therapy with statins and LDL-apheresis via the heparin-induced method is given to heart transplant patients to determine whether drastic lowering of fibrinogen, LDL-C, and Lp(a) prevent graft vessel disease (GVD). Results demonstrate that combined treatment prevents GVD in 9 of 10 patients.
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Regression of Transplant Coronary Artery Disease During Chronic Low-Density Lipoprotein-Apheresis
Park J-W, Merz M, Braun P.
J Heart Lung Transplant. 1997;16:290-297.
In long-term heart transplantation survivors with hyperlipidemia who have development of a rapid progressive coronary artery disease, LDL-apheresis can encourage disease regression.
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Peripheral Vasoactivity in Familial Hypercholesterolemic Subjects Treated With Heparin-Induced Extracorporeal LDL Precipitation (HELP)
Stadler RW, Ibrahim SF, Lees RS.
Atherosclerosis. 1997;128:241-249.
The effect of LDL-apheresis on vasoactivity is examined in this review, which concludes that therapy via the heparin-induced method improves vasoactivity in patients with severe familial hypercholesterolemia.
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Additional Citations
Plasmalogen Phospholipids in Plasma Lipoproteins of Normolipidemic Donors and Patients With Hypercholesterolemia Treated by LDL Apheresis
Brautigam C, Engelmann B, Reiss D, et al.
Atherosclerosis. 1996;119:77-88.
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Treatment of Hypercholesterolemia With Heparin-Induced Extracorporeal Low-Density Lipoprotein Precipitation (HELP)
Lees RS, Holmes NN, Stadler RW, Ibrahim SF, Lees AM.
J Clin Apheresis. 1996;11:132-137.
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Long-Term Effect of LDL-Apheresis on Coronary Heart Disease
Richter WO, Donner MG, Schwandt P.
Acta Angiologica. 1996;2:147-151.
Full abstract not available.
Fast Transmission of Alterations in Plasma Phosphatidylcholine/Sphingomyelin Ratio and Lyso Phosphatidylcholine Levels into Changes of Red Blood Cell Membrane Phospholipid Composition After Low Density Lipoprotein Apheresis
Kulschar R, Engelmann B, Brautigam C, Duhm J, Thiery J, Richter WO.
Eur J Clin Invest. 1995;25:258-265.
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Changes in Plasma Lipid and Apolipoprotein Levels Between Heparin-Induced Extracorporeal Low-Density Lipoprotein Precipitation (HELP) Treatments
Lane DM, Alaupovic P, Knight-Gibson C, Dudley VS, Laughlin LO.
Am J Cardiol . 1995;75:1124-1129.
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In Vitro and In Vivo Studies With Different Precipitate Filter Cartridges for HELP-LDL-Apheresis: Optimization of Precipitate Filter Cartridges
Morsch G, Maywald F, Wanner C.
Bioseparation. 1995;5:11-18.
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Regression of Transplant Coronary Artery Disease During Chronic HELP Therapy: A Case Study
Park J-W, Vermeltfoort M, Braun P, May E, Merz M.
Atherosclerosis. 1995;115:1-8.
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Lack of Plasma Lipid Peroxidation During LDL-Apheresis by Heparin-Induced Extracorporeal LDL-Precipitation
Wieland E, Schettler V, Creutzfeldt C, Kickbusch H, Schuff-Werner P.
Eur J Clin Invest. 1995;25:838-842.
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Reversible Reduction of Phospholipid Bound Arachidonic Acid After Low Density Lipoprotein Apheresis: Evidence for Rapid Incorporation of Plasmalogen Phosphatidylethanolamine into the Red Blood Cell Membrane
Engelmann B, Brautigam C, Kulschar R, et al.
Biochim Biophys Acta. 1994;1196:154-164.
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Advances in LDL-Apheresis for the Treatment of Severe Hypercholesterolemia
Gordon BR, Saal SD.
Curr Opin Lipidol. 1994;5:69-73.
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Reverse Flux Filtration: A New Mode of Therapy Improving the Efficacy of Heparin-Induced Extracorporeal LDL Precipitation in Hyperlipidemic Hemodialysis Patients
Bosch T, Samtleben W, Thiery J, Gurland HJ, Seidel D.
Int J Artif Organs. 1993;16:75-85.
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LDL Apheresis in the Treatment of Severe Hyperlipidemia
Gordon BR.
Primary Cardiol. 1993;19:53-56.
Full abstract not available.
Weekly Treatment of Diet/Drug-Resistant Hypercholesterolemia With the Heparin-Induced Extracorporeal Low-Density Lipoprotein Precipitation (HELP) System by Selective Plasma Low-Density Lipoprotein Removal
Lane DM, McConathy WJ, Laughlin LO, et al.
Am J Cardiol. 1993;71:816-822.
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Extracorporeal Treatment of Hypercholesterolemia
Olbricht CJ.
Nephrol Dial Transplant. 1993;8:814-820.
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Recent Developments in Low-Density Lipoprotein Apheresis
Demant T, Seidel D.
Curr Opin Lipidol. 1992;3:43-48.
Full abstract not available.
Treatment of Severe Hypercholesterolemia With Heparin-Induced LDL-Apheresis
Richter WO, Jacob B, Ritter MM, Sühler K, Vierneisel K, Schwandt P.
Curr Ther Res. 1992;52:317-329.
Full abstract not available.
Biocompatibility of Four Plasmapheresis Membranes in Patients Treated for Hypercholesterolemia
Bohler J, Donauer K, Koster W, Schollmeyer PJ, Wieland H, Horl WH.
Am J Nephrol. 1991;11:479-485.
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Combined LDL Apheresis and Hemodialysis in a Patient With End-Stage Renal Disease and Accelerated Coronary Atherosclerosis
Grutzmacher P, Vallbracht C, Scheuermann E, Kurz P, Schoeppe W.
ASAIO Trans. 1991;37:M435-M436.
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Regression of Carotid Plaques During Low Density Lipoprotein Cholesterol Elimination
Hennerici M, Kleophas W, Gries FA.
Stroke. 1991;22:989-992.
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LDL-Apheresis: Results of Longterm Treatment and Vascular Outcome
Keller C.
Atherosclerosis. 1991;86:1-8.
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Short- and Long-Term Effects of LDL-Apheresis on Lipoprotein (a) Serum Levels
Ritter MM, Sühler K, Richter W, Schwandt P.
Clin Chim Acta. 1990;195:9-16.
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