Suzuki Toshihide, Sato Yuichi, Niizuma Shinichiro, Kushiro Toshio, Tani Shigemasa, Ishikawa Kazutoshi, Kajiwara Nagao, Kanmatsuse Katsuo, Ikeda Hironori, Takahashi Motoichirou, Kojima Shunichi
Department of Cardiology, Surugadai Nihon University Hospital, Tokyo, Japan.
J Clin Apher. 2007;22(5):287-91. doi: 10.1002/jca.20138.
We have recognized marked effectiveness for intermittent claudication with low-density lipoprotein (LDL) apheresis in two cases of arteriosclerosis obliterans (ASO). The Case 1 was a 73-year-old man with intermittent claudication of both lower extremities (Fontaine class II), digital subtraction angiography (DSA) revealed complete obstruction of the left common iliac artery, formation of a collateral to the peripheral portion of the left common iliac artery, and diffuse stenosis of the peripheral portion of the right common iliac artery. Ten sessions of LDL apheresis (LDL-A) improved the walking distance from 100 m before to 600 m after LDL-A treatment. The Case 2 was a 61-year-old man with intermittent claudication of the left lower extremity (walking distance: 200 m) began at 59 years. DSA revealed diffuse stenosis of the peripheral portion of the left popliteal artery. Ten sessions of LDL-A improved the walking distance from 200 m before to 800 m after LDL-A. At one month after the end of LDL-A treatment, DSA revealed formation of collateral to the peripheral portion of the left popliteal artery. Our findings suggest that LDL-A combined with drug treatment is safe and useful for the treatment of ASO, especially walking distance improved with short term treatment.
我们已认识到，在两例动脉硬化闭塞症（ASO）患者中，低密度脂蛋白（LDL）单采术对间歇性跛行具有显著疗效。病例1是一名73岁男性，双下肢间歇性跛行（Fontaine II级），数字减影血管造影（DSA）显示左髂总动脉完全闭塞，左髂总动脉外周部分形成侧支，右髂总动脉外周部分弥漫性狭窄。10次LDL单采术（LDL-A）将步行距离从术前的100米提高到LDL-A治疗后的600米。病例2是一名61岁男性，59岁时开始出现左下肢间歇性跛行（步行距离：200米）。DSA显示左腘动脉外周部分弥漫性狭窄。10次LDL-A将步行距离从术前的200米提高到LDL-A治疗后的800米。在LDL-A治疗结束后1个月，DSA显示左腘动脉外周部分形成侧支。我们的研究结果表明，LDL-A联合药物治疗对ASO的治疗是安全有效的，尤其是短期治疗可改善步行距离。
