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A Critical Review on the Use of Lipid Apheresis and Rheopheresis for Treatment of Peripheral Arterial Disease and the Diabetic Foot Syndrome
Author(s) -
Weiss Norbert
Publication year - 2011
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2011.01036.x
Subject(s) - medicine , apheresis , critical limb ischemia , arterial disease , coronary artery disease , peripheral , cardiology , vascular disease , context (archaeology) , disease , ldl apheresis , intensive care medicine , platelet , paleontology , biology
Lipid apheresis effectively lowers LDL‐cholesterol even in drug‐unresponsive severely hypercholesterolemic patients. This results in improvement of symptoms of coronary artery disease, reduces progression of coronary atherosclerosis, and decreases coronary event rates. Besides aggressive lipid lowering itself, these effects may also be due to nonselective removal of other high molecular weight proteins leading to improved hemorheology. Lipid apheresis is also used for treating symptoms of vascular diseases outside the coronary arteries, such as peripheral arterial disease and the angioneuropathic diabetic foot syndrome. This review discusses putative effects of lipid apheresis and rheophereis on restoring pathophysiological processes involved in the development of symptoms of peripheral arterial disease, critical limb ischemia, and the diabetic foot syndrome. The clinical experience with lipid apheresis and rheopheresis in treating patients with peripheral arterial disease and the diabetic foot syndrome is critically reviewed and put into the context of currently available established treatment options. Based on this analysis, the limitations of current evidence are discussed and potential fields of research are suggested.