PROGNOSIS OF PATIENTS WITH ARTERIOSCLEROSIS OBLITERANS TREATED WITH LDL-APHERESIS

A total of 55 arteriosclerosis obliterans (ASO) patients with hypercho lesterolemia (total cholesterol [TC] greater-than-or-equal-to 220 mg/d L or low density lipoprotein cholesterol [LDL-C] greater-than-or-equal -to 140 mg/dL) were treated with LDL-apheresis. A follow-up questionna ire was sent to 39 of these patients by mail. Reported herein are effe cts of the LDL-apheresis and prognosis in 26 patients (17 men and 9 wo men) who undertook the LDL-apheresis and responded to the follow-up qu estionnaire. The subjective symptoms reported were investigated at thr ee stages: before the treatment, immediately after the final LDL-apher esis, and at the follow-up observation time (March, 1993). An LDL-chol esterol level was reduced from 171 +/- 30 (mean +/- SD) to 83 +/- 39 m g/dL by 10 +/-3 applications of the apheresis. No aggravation in clini cal symptoms was observed in any patient. Improvement rates of the cli nical symptoms immediately after the final LDL-apheresis in these part icular patients were as follows: foot chillness 52%, foot numbness 58% , foot dullness 81%, intermittent claudication 62%, foot pain at rest 75%, and ulcer at toes 100%. According to analysis of the questionnair e, these improvements in the clinical symptoms have been maintained at relatively high rates such as 69% in foot chillness, 91% in foot numb ness, 100% in foot dullness, 81% in intermittent claudication, 89% in foot pain at rest, and 100% in ulcer at toes for 1.2 +/- 0.8 (0.1 to 2 .4) years of the observation period. The improvements are suggested to be due to the amelioration in peripheral blood flow as evidenced by d evelopment of new collaterals observed on arteriograms.