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Angiology
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LDL Apheresis for Arteriosclerosis Obliterans with Occluded Bypass Graft: Change in Prostacyclin and Effect on Ischemic Symptoms

Shinsuke Mii, MD

Department of Surgery Nippon Steel Corporation Yawata Works Hospital 1-1-1 Harunomachi, Yahatahigashi-ku Kitakyushu-City 805, Japan

Akira Mori, MD

Hisanobu Sakata, MD

Masaru Nakayama, MD

Hiroshi Tsuruta, MD

To study the mechanism of efficacy of low-density lipoprotein (LDL) adsorption for arte riosclerosis obliterans (ASO), eight ASO patients without indication for bypass surgery underwent LDL apheresis twice a week for 5 weeks and the change in prostaglandin I2 (PGI 2) and thromboxane A2 (TXA2) due to LDL apheresis was measured. The concentra tion of 6-keto-PGFI,, a metabolite of PGI2, in systemic venous blood significantly increased from 10.4 ± 1.8 to 42.0 ± 10.6 pg/mL (P < 0.05) after one session of LDL apheresis, while no significant change of TXB2, a metabolite of TXA2, was encountered. The ratio of 6-keto-PGF,,,/TXB2 also rose dramatically from 0.213 ±0.044 to 0.522 ±0.128 (P < 0.05) . In five patients, the ischemic clinical symptoms improved and both the concentration of 6-keto-PGF1{alpha} and the ratio of 6-keto-PGF1{alpha}/TXB2 increased significantly, whereas in three patients there was no effect on clinical symptoms and neither parameter changed. These results suggest that elevated production of PGI 2 from vascular cells due to LDL apheresis might contribute to improvement of ischemic symptoms.

Angiology, Vol. 49, No. 3, 175-180 (1998)
DOI: 10.1177/000331979804900302
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