[Radical therapy of refractory hyperlipidemia: extracorporeal cholesterol elimination]

Area of Science:

• Cardiovascular Medicine
• Lipidology
• Vascular Surgery

Context:

• Atherosclerosis and hypercholesterolemia are leading causes of mortality in Austria.
• A direct correlation exists between reduced cholesterol levels and decreased coronary heart disease mortality.
• Established treatments include diet, medication, and now potent extracorporeal therapies.

Purpose:

• To highlight the efficacy of extracorporeal cholesterol-lowering therapies.
• To discuss indications for these advanced treatments.
• To explore their role in managing various forms of hypercholesterolemia and vascular disease.

Summary:

• Extracorporeal lipid-lowering procedures, especially combined with HMG-CoA reductase inhibitors, can achieve up to 80% LDL-cholesterol reduction.
• These therapies are essential for managing homozygous familial hypercholesterolemia (FH).
• They are also effective for refractory heterozygous FH, secondary hypercholesterolemia, and improving hemorheological parameters in vascular diseases.

Impact:

• Provides a critical treatment option for severe hypercholesterolemia, including genetic forms.
• Offers an alternative or adjunct therapy for patients unresponsive to conventional treatments.
• Potential to reduce mortality from atherosclerosis-related diseases and improve vascular health.