Low density lipoprotein (
LDL)
apheresis was carried out in 28 atherosclerotic patients with clinical signs of poor peripheral circulation and abnormally high
LDL levels. The
LDL apheresis using extracorporeal adsorption with a
dextran sulfate cellulose column (Liposorber, Kaneka, Japan) was done 10 times over 3 months.
Hyperlipidemia was rapidly corrected after the initial two
aphereses, whereas clinical signs of
arteriosclerosis obliterans (ASO), such as coldness of the legs in 17 of 19 patients (89.5%),
intermittent claudication in 14 of 17 patients (82.4%), foot
pain at rest in 15 of 18 patients (83.3%), poor arterial pulsation in 12 of 16 patients (75.0%), and diminution of
ulcer/
necrosis in 3 of 5 patients (60.0%), improved in parallel. Improvement in plethysmographic and thermographic findings were observed in 10 of 10 patients (100.0%) and 13 of 14 patients (92.9%), respectively. Our tentative conclusion is that
LDL apheresis using the Liposorber system was very effective in removing
LDL from blood, and clinical symptoms rapidly improved in all patients concomitant with a reduction in plasma
LDL levels.
Hyperlipidemia may be a risk factor for symptomatic ASO in the lower extremities, and its active correction may be worth trying.