Clinical impact of a novel lipoprotein apheresis treatment on no-option chronic limb-threatening ischemia: Result from the REDUCTION VISCOSITY study

Ther Apher Dial. 2023 Oct;27(5):960-967. doi: 10.1111/1744-9987.13991. Epub 2023 Apr 13.

Abstract

Introduction: Lipoprotein apheresis (LA) is a possible adjunct treatment for no-option chronic limb-threatening ischemia (CLTI). This study aimed to assess the impact of a novel LA for no-option CLTI.

Methods: We retrospectively assessed 19 patients with no-option CLTI treated using the novel LA. The primary outcome was a change in the skin perfusion pressure (SPP) after treatment with LA, and the secondary outcomes were changes in the viscosity-related laboratory parameters.

Results: The wound-healing rate was 68.4%. The SPP at 2-3 weeks after series of LA were significantly higher both in the dorsal (41 vs. 53 mmHg, p = 0.037) and plantar (50.0 vs. 61.0 mmHg, p = 0.018) sides, compared to those at baseline. The viscosity-related laboratory markers were also significantly improved after the treatment; low-density lipoprotein-cholesterol (57.0 vs. 43.0 mg/dL, p = 0.002), fibrinogen (333 vs. 258 mg/dL, p < 0.001), and C-reactive protein (0.99 vs. 0.42 mg/dL, p = 0.001).

Conclusion: The novel LA significantly increased the SPP and improved relevant laboratory findings.

Keywords: chronic limb-threatening ischemia; hemorheology improvement; lipoprotein-apheresis; skin perfusion pressure.

MeSH terms

  • Blood Component Removal*
  • Chronic Limb-Threatening Ischemia
  • Humans
  • Ischemia / therapy
  • Lipoproteins
  • Peripheral Arterial Disease*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Viscosity

Substances

  • Lipoproteins