Heparin-Induced Extracorporeal Fibrinogen/LDL Precipitation (HELP): A Promising Regimen for the Treatment of Vascular Diseases

Abstract

Current management of atherosclerotic diseases consists primarily of medical therapy designed to increase oxygen supply to the heart, the brain, retinal vessels, or lower limbs. The development of these diseases is based on atherosclerotic changes induced by risk factors such as elevated levels of fibrinogen and lipoproteins. These risk factors are related to a dramatic deterioration of the hemorrheologic pattern, which reduces perfusion. Consequently, attempts are now being made to treat ischemia via hemorrhe ological intervention. A new treatment modality utilizing the heparin-induced extracor poreal low-density lipoprotein (LDL) precipitation (HELP), offers the possibility of obtaining therapeutic success not only in cases of severe hypercholesterolemia but also in the field of hemorrheology. With HELP a safe and rapid reduction of fibrinogen and lipid fractions has become feasible, thus providing acute improvements of red cell aggregation, of the filterability of blood cells, of whole-blood and plasma viscosity, and thereby of microcirculation. Because cerebrovascular diseases are known to be related to distur bances of the hemorrheological situation, the HELP system is used in the Department of Electrobiology of Graz for the treatment of acute stroke, cerebral multiinfarct disease, and occlusions of retinal arteries.

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