Prognosis of Patients with Arteriosclerosis Obliterans Treated with LDL-Apheresis

Abstract

A total of 55 arteriosclerosis obliterans (ASO) patients with hypercholesterolemia (total cholesterol [TC] ≥ 220 mg/dL or low density lipoprotein cholesterol [LDL-C] ≥ 140 mg/dL) were treated with LDL-apheresis. A follow-up questionnaire was sent to 39 of these patients by mail. Reported herein are effects of the LDL-apheresis and prognosis in 26 patients (17 men and 9 women) who undertook the LDL-apheresis and responded to the follow-up questionnaire. The subjective symptoms reported were investigated at three stages: before the treatment, immediately after the final LDL-apheresis, and at the follow- up observation time (March, 1993). An LDL-cholesterol level was reduced from 171 ±30 (mean ±SD) to 83 ±39 mg/dL by 10 ±3 applications of the apheresis. No aggravation in clinical symptoms was observed in any patient. Improvement rates of the clinical symptoms immediately after the final LDL-apheresis in these particular patients were as follows: foot chillness 52%, foot numbness 58%, foot dullness 81%, intermittent claudi cation 62%, foot pain at rest 75%, and ulcer at toes 100%. According to analysis of the questionnaire, these improvements in the clinical symptoms have been maintained at relatively high rates such as 69% in foot chillness, 91% in foot numbness, 100% in foot dullness, 81% in intermittent claudication, 89% in foot pain at rest, and 100% in ulcer at toes for 1.2 ± 0.8 (0.1 to 2.4) years of the observation period. The improvements are suggested to be due to the amelioration in peripheral blood flow as evidenced by devel opment of new collaterals observed on arteriograms.

Get full access to this article

View all access options for this article.

References

Homma Y. , Mikami Y. , Tamachi H. , et al: Comparison of selectivity of LDL removal by double filtration and dextran-sulfate cellulose column plasmapheresis, and changes of subfractionated plasma lipoproteins after plasmapheresis in heterozygous familial hypercholesterolemia . Metabolism 39:419-425, 1987.

Agishi T. , Kitano Y. , Suzuki T. , et al: Improvement of peripheral circulation by low density lipoprotein adsorption. ASAIO Transaction 35:349-351, 1989.

Agishi T. , Naganuma S. , Nakasato S. , et al: Treatment of arteriosclerotic obstruction by LDL adsorption . Angiology 44:222-227, 1993.

Naganuma S. , Agishi T. , Ota K. : Low density lipoprotein apheresis in atherosclerosis disease with hyperlipidemia . Therapeutic Plasmapheresis 1993, ed. by Agishi T, et al, 12:439-441.