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Procedure filters out bad cholesterol

March 10, 2009 12:00:00 AM PDT
If you have a high level of bad cholesterol in your blood, why not filter it out? It sounds simple, but it may be easier said than done.High cholesterol is considered a number of 240 or higher. More than 24 million American adults have high cholesterol and, for some, diet, exercise and medication won't help. But patients now have another option: a filter for bad cholesterol.

Ted Harrison says the more he plays billiards, the luckier he gets. For the last 20 years, he has been trying to use that luck to win the fight against his body.

"I had radical throat cancer, I had open heart surgery, I have had nine stents put in," said Harrison.

Ted also currently has extremely high levels of LDL, or "bad cholesterol." His high cholesterol is genetic. So changing his diet, exercising and medication didn't help. But Ted is one of the first to have his bad cholesterol removed from his body.

Endocrinologists at Washington University in Saint Louis are using HELP -- heparin-induced extracorporeal lipoprotein precipitation -- to control Ted's cholesterol.

The blood is separated into red cells and plasma. The plasma runs through a machine which grabs on to a protein found in LDL and removes it from the blood, filtering out the bad cholesterol. The cleaned plasma is put back together with the red blood cells and returned to the body.

"This is the most efficient process for lowering LDL because it happens immediately," said Dr. Anne Carol Goldberg, endocrinologist, Washington University.

Ted's LDL level went from over 200 to under 100 after one treatment. But the bad cholesterol will build back up within weeks, so Ted will have the procedure twice a month, indefinitely.

"Any cholesterol you can keep out of your arteries that builds plaque is good," said Ted.

A normal LDL level is under 100. To be eligible for the filter, a person must have an LDL level of at least 300, or 200 if they have heart disease. The procedure is offered at a few dozen locations across the United States.

Web extra information about filtering out bad cholesterol:

Background
Although cholesterol itself isn't bad, having too much of it or an improper balance of "good" and "bad" cholesterol is bad news. "Good" cholesterol is called high-density lipoprotein and makes up one-fourth to one-third of blood cholesterol, says the American Heart Association. Low-density lipoprotein is also known as "bad" cholesterol. If too much LDL circulates in the blood, it can build up on the inner walls of the arteries that feed the heart and brain. This can eventually form plaque that narrows that arteries and leaves a person at high risk for heart attack or stroke.

A Genetic Problem
When most people hear the term "high cholesterol," they immediately think of an unhealthy lifestyle, but some people are born with the problem. Inherited bad cholesterol characterized by high levels of LDL is called familial hypercholesterolemia, and it affects about one in every 500 people. About one in 1 million people inherit a defective LDL receptor gene, causing them to have cholesterol levels of between 700 and 1,200. The American Heart Association says optimal levels of LDL are less than 100.

Treatments
Proper diet, exercise and some medications can bring LDL levels down to safer levels for people with familial hypercholesterolemia and others forms of high cholesterol. The National Institutes of Health recommends reducing fat intake by eating less beef, pork and lamb; choosing low-fat dairy products; and avoiding coconut and palm oil. It also helps to reduce cholesterol intake by avoiding egg yolks, organ meats and sources of animal-derived saturated fat. Although diet adjustments like these and stain drugs may improve LDL levels in people with the less severe form of familial hypercholesterolemia, those with the more severe form of the disease may need help beyond that.

Dialysis for Bad Cholesterol
For people with high cholesterol who won't respond to medication, hope comes in the form of a system called Heparin-induced Extracorporeal Lipoprotein Precipitation, or HELP. Treatment with HELP involves a machine that literally filters bad cholesterol out of the blood. After blood is drawn from the patient, it's separated into red cells and plasma and the plasma runs through the machine. Material in the HELP machine grabs on to bad cholesterol particles and removes them from the blood. The plasma is then put back together with red blood cells and returned to the body. The entire process is known as LDL apheresis and takes an hour and a half to two hours for the patient. Although uncommon, possible side effects of LDL apheresis include increased bleeding after the procedure, too much or too little fluid in the bloodstream, air in the bloodstream and low blood pressure

(Source: Mayo Clinic).

For more information:
Judy Martin
Media Relations
Washington University School of Medicine
St. Louis, MO
(314) 286-0105


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