EXTRACORPOREAL FIBRINOGEN AND PLATELET PRECIPITATION AS A NEW HEMORHEOLOGICAL TREATMENT FOR ACUTE STROKE

In thromboembolic brain infarctions high fibrinogen levels are associa ted with an increase of both plasma and whole blood viscosity as well as increased aggregability of blood cells. This decreases cerebral per fusion and might reduce blood flow in the penumbra surrounding infarct ion. An important goal in the treatment of acute cerebral infarction i s to reduce fibrinogen and thereby improve the haemorheological state. Heparin-induced extracorporeal low-density lipoprotein/fibrinogen pre cipitation (HELP) appears to be successful in achieving this. Such tre atment reduces lipid fractions, including total cholesterol, low-densi ty lipoproteins (LDL) and triglycerides (p < 0.0001 each), as well as fibrinogen (p < 0.0001) in a safe and efficacious manner. Whole blood and plasma viscosity are also improved when measured by oscillo-rheome try. Furthermore, the number and aggregation tendency of blood cells i s influenced positively as determined by Coulter counting and aggregom etry. HELP improves the haemorheological profile to a degree which has not been achieved by haemorheologically active substances.