[LDL-apheresis--clinical indication and utility].

LDL-apheresis is now sprended as a special technique for reducing serum cholesterol in drug-resistant patients with severe hypercholestrolemia. It's indication should be limited to homozygous familial hypercholesterolemia (FH) and lipid-uncontrollable heterozygous FH cases with coronary artery disease. Long-term effectiveness of LDL-apheresis on coronary events and lesions was established. This method may be useful to prevent graft vessel disease in patients with heart transplantation in the future. The clinical efficacy of this method may be induced not only by the removal of large amount of cholesterol but also by the resistance of LDL-oxidation or the improvement of endothelium-dependent vasodilatation.