[Mechanisms of the positive clinical effect of plasmapheresis for arteriosclerosis obliterans in the lower extremities].

Some mechanisms of clinical improvement of peripheral atherosclerosis were studied on the basis of changes occurred in hemorheological parameters and lipid spectrum in 107 patients with atherosclerosis obliterans of the lower extremity vessels who had undergone 166 courses (468 sessions) of therapeutical plasmapheresis. In addition to improved lower extremity blood flow in 94.8% of patients with Stage II ischemia and 78.2% with Stage III, clinically improved cerebral circulation was seen in 87.6% and clinically better coronary circulation in 85.2%. This suggests definite unique hemodynamic effects of plasmapheresis. The paper also indicates that there are at least three mechanisms providing a positive clinical effect of plasmapheresis in peripheral atherosclerosis: (1) peripheral macro- and microhemodynamic improvement due to decreased levels of plasma and perimembrane fibrinogen and increased erythrocyte deformability; (2) a decrease in thrombus risk due to lower fibrinogen levels and fibrinolytic activation; (3) monitoring risk factors of atherosclerosis due to lower levels of atherogenic lipoproteins, triglycerides, and cholesterol.