- With Mayo Clinic cardiologist
Thomas Behrenbeck, M.D.
read biographyclose windowBiography of
Thomas Behrenbeck, M.D.
Thomas Behrenbeck, M.D.
Dr. Thomas Behrenbeck is a native of Germany, where he received his medical education at the Westfalian Wilhelm University in Munster and became board certified in internal medicine and cardiology.
He also received a Ph.D. in biophysics and physiology at the University of Minnesota. Dr. Behrenbeck joined the Mayo Clinic staff in 1990 and is currently an associate professor at Mayo Medical School and an academic faculty member at the Westfalian Wilhelm University. He is chair of the Cardiovascular Medicine and Surgery NetWork of the American College of Chest Physicians.
Dr. Behrenbeck is a noninvasive cardiologist, specializing in cardiovascular (CV) imaging modalities (echocardiography, nuclear cardiology, and CT), coronary artery disease and prevention of coronary artery disease. His research interests are the application of imaging technology to early recognition and treatment of atherosclerosis. He is passionate about patients' involvement in their health issues.
"The Internet and patient education present ideal synergies in the ever-growing field of knowledge in cardiology," he said.
Definition (1)
- VLDL cholesterol: What is it?
Symptoms (1)
- Arcus senilis: A sign of high cholesterol?
Tests and diagnosis (3)
- Cholesterol level: Can it be too low?
- Cholesterol test kits: Are they accurate?
- Cholesterol ratio: Is it important?
Treatments and drugs (8)
- LDL apheresis: Can it lower LDL cholesterol?
- High cholesterol in children: How is it treated?
- Niacin overdose: What are the symptoms?
- see all in Treatments and drugs
Lifestyle and home remedies (4)
- Pomegranate juice: Can it lower cholesterol?
- Kefir: Can it lower my cholesterol?
- Eggs: Are they good or bad for my cholesterol?
- see all in Lifestyle and home remedies
Alternative medicine (2)
- Noni juice: Can it reduce cholesterol?
- High cholesterol treatment: Does cinnamon lower cholesterol?
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Question
LDL apheresis: Can it lower LDL cholesterol?
My husband has dangerously high cholesterol that so far has been unresponsive to drug treatment. His doctor is recommending LDL apheresis. What can you tell me about this treatment? Does it work? Is it safe?
Answer
from Thomas Behrenbeck, M.D.
LDL apheresis is a procedure used to remove low-density lipoprotein (LDL), or "bad," cholesterol from the blood. LDL apheresis can be effective for people who:
- Have heart disease and very high LDL cholesterol — higher than 200 milligrams per deciliter (mg/dL), or 5.2 millimoles per liter (mmol/L)
- Have very high LDL cholesterol that hasn't responded to diet changes or medication
LDL apheresis removes LDL cholesterol and related harmful cholesterol particles from the blood through a special filtering machine. During a treatment session — which may take three to four hours to complete — blood is removed from the body through a needle (usually placed in a vein in the arm) and sent to the filtering machine in a plastic tube. The machine removes the LDL cholesterol from the blood and then returns the "clean" blood through another vein.
LDL apheresis significantly lowers LDL cholesterol after just one treatment, but it's not a permanent solution. Because LDL apheresis doesn't correct the cause of the high cholesterol, LDL levels are likely to increase again after treatment. Typically, LDL apheresis must be repeated every one to two weeks. It's also essential to continue taking cholesterol-lowering medications and to follow a healthy, low-fat diet.
LDL apheresis is a safe procedure with a low risk of side effects. Though uncommon, possible complications may include:
- Increased bleeding in the days following the procedure
- Infection
- Too much or too little fluid in the bloodstream
- Air in the bloodstream (air embolism)
- Low blood pressure during the procedure and for a few hours afterward
LDL apheresis isn't an option for anyone who has a blood disorder that makes it difficult for blood to coagulate, such as hemophilia or von Willebrand disease.
Because LDL apheresis is still a relatively new treatment, it's available only in a limited number of health care facilities.
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