LDL apheresis therapy for critical limb ischemia

Abstract

Re-vascularization therapy is essential as limb salvage strategy in patients with critical limb iscmeia (CLI). Although endovascular therapy (EVT) or surgical bypass is performed, restenosis rate after EVT for below knee arteries (BKA) in hemodialysis (HD) patients is surprisingly high. Preliminary study comparing EVT alone or hybrid therapy of EVT plus LDL apheresis for BKA-EVT in HD patients in our hospital showed favorable results for preventing restenosis of target vessels. Synergistic beneficial effect might be expected for limb salvage in patients with severe CLI by not only performing local re-vascularization therapies, but also by combining them with LDL apheresis, i.e., systemic therapy which improve whole blood rheology and have anti-inflammatory effect.