Lipid metabolism disorders - Lipid apheresis

symbol_kamera_xsmall.png  Lipid apheresis - Specifically remove LDL cholesterol and lipoprotein(a) (presently only available in German) 

video_1.png    Start video

Blood lipids and atherosclerosis

Atherosclerosis (hardening of the vessels) is caused by the interaction of various risk factors. The focus here is an excessive concentration of lipoproteins ("blood fats") in the blood. These can penetrate the walls of the blood vessels and lead to deposition processes up to vascular occlusion. Patients with this fat metabolism disorder often suffer from atherosclerosis at an early stage. The risk of suffering a heart attack or stroke is often greatly increased as is the likelihood of peripheral arterial occlusion (PAO). Often, the quality of life is also highly restricted. 

arteriosklerose_prinzip.png
Atherosclerosis: Depostion processes can lead to vascular occlusion

Disorders of the LDL cholesterol metabolism

Lipid metabolism disorders may result in very high LDL cholesterol levels in the blood. Primary lipid metabolism disorders are based on various inheritable metabolic disorders, especially familial hypercholesterolemia. In the severe homozygous form of the disease, there are no fully functional LDL receptors; in the heterozygous form in most cases they are only partially intact. These receptors are supposed to direct the LDL cholesterol from the blood into the cells, for example the liver, and to add them to the metabolism. Therefore, LDL cholesterol accumulates in the blood of affected patients without therapy: 600 to 1,500 mg/dl in the homozygous and over 300 mg/dl in the heterozygous form. In addition, there are also secondary lipid metabolism disorders that develop as a consequence of other diseases such as diabetes mellitus. 

schema_lipidapherese_16.JPG
Principle of Lipidfiltration

In homozygous hypercholesterolemia, the LDL cholesterol can only be sufficiently removed from blood by lipid apheresis to prevent a severe atherosclerosis already in childhood. In heterozygous hypercholesterolemia and secondary fat metabolism, lipid apheresis is used in severe cases when the LDL cholesterol level cannot be lowered sufficiently by diet and medication. 

Increased lipoprotein(a)

Another lipoprotein is gaining more and more importance - the so-called lipoprotein(a), abbreviated as "Lp(a)". It is very similar to the LDL cholesterol in its structure. Lipoprotein(a) is recognized as an independent risk factor for the development of atherosclerosis or coronary artery disease. The risk associated with lipoprotein(a) concerns mainly the early onset of an arterial vascular disease. In addition, lipoprotein(a) can increase the risk of LDL cholesterol. This combination of simultaneously increased LDL cholesterol and lipoprotein(a) in the blood is considered as particularly risky by experts. The amount of lipoprotein(a) each one of us has in our blood is highly hereditary and cannot really be influenced by medication. From a value of 30 mg/dl, the risk of coronary heart disease is currently regarded as increased. 

Do you know your Lp(a) level?
lipoproteine_neu_16.JPG
LDL cholesterol (left-hand) and lipoprotein(a)

With the help of lipid apheresis, it is possible to lower the LP(a). The lipid filtration developed by DIAMED can lower lipoprotein(a) by up to 75% per therapy session, thus preventing further progression of coronary heart disease. However, the indication for lipid apheresis cannot only be determined by the amount of lipoprotein(a). Rather, we have to take into account the respective entire cardiovascular risk profile and the individual progression of the disease. In addition, it is important to know whether or not similar diseases have already occurred in the family of the patient. Lipid apheresis is used when in addition to a greatly increased Lp(a) value (> 60 mg/dl), a progressive cardiovascular disease has been proven. 

Description of Lipidfiltration

Gerneral information on apheresis

Lipid apheresis - FAQ 

When is lipid apheresis carried out?
Lipid apheresis (also known as LDL apheresis) is carried out when LDL cholesterol cannot be lowered sufficiently in spite of maximum diet and drug therapy. Please note that in the case of additional risk factors such as diabetes or cardiovascular disease, the LDL target that must be reached is lower.

Patients with increased lipoprotein(a) and a progressive cardiovascular disease (coronary heart disease, peripheral arterial occlusive disease, cerebrovascular disorders) are also treated with lipid apheresis. Lipoprotein(a) can only be lowered to a maximum of 20 - 30% with the medication that is currently available. 

Does lipid apheresis replace cholesterol-lowering medication?
In order to achieve the targeted reduction, cholesterol-lowering drugs must be continued even after commencing lipid apheresis in most cases. 

Where is lipid apheresis carried out?
Lipid apheresis is a blood cleansing procedure and is therefore carried out by many doctors who also offer dialysis. In addition, there are also specialized apheresis centers and specialist departments of clinics and hospitals which offer lipid apheresis. The experts of the Apheresis Research Institute will be happy to advise you.  

How often must lipid apheresis be carried out?
The treatment is usually carried out once per week or every 14 days. 

How long does one lipid apheresis take?
Each treatment takes approximately 1.5 to 3 hours. 

How is lipid apheresis carried out?
Lipid apheresis is carried out on an outpatient basis; after the treatment, you can continue to follow your normal routine. Lipid apheresis takes place on a couch and you can, for example, watch television. The picture shows a lipid apheresis in an apheresis center. 

therapie_apherese-2.png

Do health insurances cover lipid apheresis?
The costs of lipid apheresis are completely covered by health insurances in Germany, based upon reimbursement guidelines including an individual application. Your specialist doctor can give you further information.

In principle, we recommend that you consult the doctor who is treating you.

For a better understanding of other technical terms, please also refer to our glossary

logo_e-mail_orange_xs.png Do you have any questions about lipid apheresis? Then we would be happy to help you: diamed(at)diamed.de. Or feel free to use our contact form.

©2018 DIAMED Medizintechnik GmbH