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Yaroustovsky et al. Vessel Plus 2019;3:9 I http://dx.doi.org/10.20517/2574-1209.2019.02 Page 9 of 11

improves blood rheology temporarily, but careful monitoring of proteins and immunoglobulin levels
changes is needed to provide the safety of the treatment. Development of new membranes with different
cut-off points (permeability) and improvement of equipment will enable safe and effective double or triple
filtration in the near future. These hollow fibers will be manufactured with pores of certain size. They will
allow performing selective and quite accurate filtration. The main clinical benefit will be the possibility
to preserve important physiological proteins, coagulation factors, hormones and enzymes. Thus, cascade
rheofiltration methodology can be attributed to the selective lipid apheresis sessions group.

As a result of our study and based on the data of the other researchers, we can notice about successful
application of therapeutic apheresis in the complex treatment of patients with multifocal atherosclerosis and
its complications. This type of treatment is safe and highly effective for dyslipidemia corrections, elimination
of atherogenic lipoproteins, stabilization of atherosclerotic process and endothelium state, hemostasis
correction and immunological indications, metabolism disorders, etc.

Extracorporeal therapy for lipid metabolism disorders should be tailored to the individual patient condition,
depending on clinical and laboratory parameters of the patient (type of dyslipidemia, hemostasis state,
comorbidities). Besides, the priority attention while choosing the apheresis method is given to staff expertise
and technical capabilities of the clinic.

Lipid apheresis techniques should be applied for primary and secondary prevention of atherosclerosis
events in the context of severe disorders of lipid metabolism, refractory and conventional therapy (diet,
medications) to improve the treatment prognosis and the quality of life of the high-risk group of patients.
Blood purification techniques are known to have high cost, and not all the medical centers are able to apply
them for complex therapy of cardiovascular diseases. But this tendency is evolving and penetrating the
clinical practice.

DECLARATIONS
Author’s contributions
Contributed to the conception, design and methodology of the study, analysed the results and wrote the
manuscript: Yaroustovsky M, Abramyan M
Collected samples and provided clinical data: Rogalskaya E, Komardina E
Read and approved the final manuscript: All authors

Availability of data and materials
The relevant data in this study can be obtained from corresponding author.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
The related study was approved by the Local Ethics Committee of the A.N.Bakulev NMRCCVS. Patients
included in the study signed an informed consent for extracorporeal therapy.

Consent for publication
Not applicable.