[Reducing low density lipoprotein-cholesterol levels by apheresis].

The predominate number of homozygote familial hypercholesterolemic and approximately 20% of heterozygotes are resistant to low cholesterol diet and lipid lowering pharmacological treatment even in combination of 2 or more drugs. In such cases, the selective lipoprotein apheresis has become a promising alternative and indicated absolute (homozygotes) or relative (heterozygotes). The combination of low density lipoprotein apheresis, together with diet and drugs, should allow a maximal lowering of low density lipoprotein-cholesterol (-60-70%). Besides low density lipoprotein, various apheresis procedures may also eliminate other potentially atherogenic factors, such as lipoprotein(a) and fibrinogen and acutely improve the haemo-rheological status of the patient. The authors review several lipoprotein apheresis procedures with varying degrees of selectivity, those have and furthermore analysis the advantages and disadvantages and cost of each procedure.