Increased cerebral perfusion following reduction of fibrinogen and lipid fractions.
High levels of plasma fibrinogen in cerebrovascular disease cause deterioration in the hemorheologic pattern, microcirculation and cerebral perfusion. We compared the value of heparin-induced extracorporeal LDL precipitation (HELP) which is a method that safely and effectively reduces plasma fibrinogen and lipoproteins and so improves the hemorheologic pattern and blood flow properties. Regional cerebral blood flow (rCBF) was measured by the 133Xe SPECT clearance method. After first measuring rCBF, 15 patients suffering from cerebral multi-infarct disease underwent a single HELP application. One hour later a second measurement of rCBF was performed. Fifteen other patients with similar clinical symptoms and findings on CAT scans who were not subjected to HELP served as controls. The HELP treatment produced an immediate and statistically significant reduction of all parameters relevant to hemorheology, such as plasma fibrinogen, whole blood viscosity at both high and low shear rate, plasma viscosity, and red cell transit time. Total cholesterol, low density lipoprotein, and triglycerides were also reduced. The treated group showed 9.7-19.9% increased rCBF in different vascular regions examined relative to the untreated controls. The results obtained indicate that HELP has a potent effect in a situation demanding rapid and significant improvement of the blood flow.
Walzl
B
B
Department of Neurology, Karl Franzens University, Graz, Austria.
Walzl
M
M
Valetitsch
H
H
Lechner
H
H
D000368:Aged; D001781:Blood Component Removal / Q000379:methods*; D002560:Cerebrovascular Circulation; D015161:Dementia, Multi-Infarct / Q000628:therapy*; D005260:Female; D005340:Fibrinogen / Q000302:isolation & purification*; D005590:Fractional Precipitation; D006493:Heparin; D006801:Humans; D008074:Lipoproteins / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow
D008074:Lipoproteins; D005340:Fibrinogen; D006493:Heparin