LDL APHERESIS USING THE LIPOSORBER(R) LA-15 SYSTEM IN CORONARY AND PERIPHERAL VASCULAR-DISEASE ASSOCIATED WITH SEVERE HYPERCHOLESTEROLEMIA

Lowering total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels is widely recommended for the prevention of coronary heart disease (CHD) and for the management of patients with existing CHD. In most patients, dietary modification and drug therapy are often sufficient to lower LDL-C levels to within acceptable ranges as recommended by the National Cholesterol Education Program Guidelines. However, for some patients, particularly those with familial hypercholesterolemia (FH), additional therapy may be required to achieve desired cholesterol levels. In those patients for whom diet and maximum drug therapy are either ineffective or not tolerated, LDL-apheresis has been shown to be a safe and effective procedure. The Liposorber(R) LA-15 system is an LDL-apheresis system that selectively removes apolipoprotein B-containing lipoproteins, including LDL-C, very-low-density lipoprotein, and lipoprotein(a). In addition to its role in treating patients with FH, preliminary data also suggest that LDL-apheresis may be beneficial in the prevention of restenosis after percutaneous transluminal coronary angioplasty, the treatment of focal glomerular sclerosis, and the management of arteriosclerosis obliterans. The present paper discusses the main components of the Liposorber LA-15 system, the principles that underlie LDL-apheresis, and the clinical conditions in which the system has been used effectively.