FIRST EXPERIENCES WITH THE HEPARIN-INDUCED EXTRACORPOREAL LOW-DENSITY-LIPOPROTEIN PRECIPITATION IN THE TREATMENT OF CRITICAL LIMB ISCHEMIA - A NEW THERAPEUTIC APPROACH

The heparin-induced extracorporeal low-density lipoprotein (LDL) preci pitation (HELP) system is based on the fact that besides lipoproteins even fibrinogen, which seems to be a very important factor in pathogen esis of peripheral arterial disease, is precipitated by high-dose hepa rin at acid pH values. The elimination of excess fibrinogen and lipopr oteins, in particular LDL, leads to a markedly improved microcirculati on. The restoration of the latter obviously enabled us to perform limb -saving surgical procedures instead of mutilating amputations. 12 pati ents suffering from peripheral arterial disease were submitted to 18 H ELP treatments in each case instead of having their critically ischaem ic legs removed. Surgery could be limited to necrosectomy only and the wounds were either primarily sutured or covered with skin grafts. We were able to avoid 13 amputations in these 12 patients who could final ly walk out of the hospital. HELP treatment was free of side effects i n all of them.