title: Heparin-mediated extracorporeal LDL precipitation treating a peripheral arterial disease patient suffering from repeated postoperative bypass occlusion.
abstract: Acute occlusion of a peripheral artery is a serious complication in peripheral arterial disease (PAD). Traditionally open surgical intervention in combination with antithrombotic therapy is the choice for treatment but the beneficial effects of both strategies are limited often by the patient's situation and therapeutic side effects. Heparin-mediated extracorporeal low-density lipoprotein precipitation (H.E.L.P.) apheresis efficiently removes circulating atherogenic lipoproteins, fibrinogen and C-reactive proteins as well as various proinflammatory and procoagulatory factors. We first report H.E.L.P. apheresis treating a PAD patient suffering from repeated postoperative femoropopliteal bypass graft occlusion, first, intensively, followed by weekly intervals. Limb amputation was avoided and the patient is doing well now. Angiography revealed bypass graft remained patent half a year after operation. This case report might help to design the regime for preventing postoperative bypass occlusion in patients with hyperlipidemia or hyperfibrinogenemia.
authors.affiliation: Institut of Clinical Chemistry, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany. frithjof.blessing@klch.med.uni-meuchen.de
authors.forename: Frithjof Josef
authors.initials: FJ
authors.lastname: Blessing
authors.forename: Beate
authors.initials: B
authors.lastname: Jaeger
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Autar K
authors.initials: AK
authors.lastname: Walli
authors.forename: Dietrich
authors.initials: D
authors.lastname: Seidel
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D001781:Blood Component Removal / Q000379:methods*; D011232:Chemical Precipitation; D005260:Female; D005263:Femoral Artery; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood / Q000302:isolation & purification*; D011150:Popliteal Artery; D012008:Recurrence
chemical_list: D008077:Lipoproteins, LDL; D006493:Heparin