Lipid apheresis is a specialist medical procedure in which certain fats in the blood, mainly cholesterol or so-called triglycerides, are removed directly from the blood to reduce the risk of serious heart and blood vessel conditions.
What exactly happens during lipid apheresis?
During this treatment, blood is passed outside the body through a special filter system. There, excess fats, such as "bad" LDL cholesterol, are filtered out before the cleaned blood is returned. The technique is similar to dialysis, which is familiar to people with kidney conditions. Lipid apheresis is only used when other measures, such as medicines or changes to diet, are not working well enough.
The aim is to significantly lower the level of harmful fats in the blood. For people who have a genetically caused lipid disorder (such as familial hypercholesterolaemia), or who continue to have extremely high cholesterol levels after a heart attack despite maximum treatment, this method can be life-saving.
Who is this treatment for?
Lipid apheresis is not carried out for every raised cholesterol level. It is a very targeted treatment, considered mainly when the risk of serious heart and circulatory conditions is particularly high. This applies especially to people for whom medicines are not enough or cannot be tolerated, and who have already had complications such as a heart attack, stroke, or poor circulation.
These are often patients with rare, inherited lipid disorders. In these conditions, the body produces too much "bad" cholesterol from birth, which builds up in the blood vessels and can cause dangerous narrowing even at a young age. In such cases, the regular removal of fats through lipid apheresis can slow the progression of the condition and prevent new complications.
How does the treatment work?
Lipid apheresis usually takes place once a week or once every two weeks. Each appointment typically lasts two to three hours. During treatment, blood is usually taken from a vein in the arm, passed through the filter system, and returned after cleaning. The procedure is well tolerated, but does require some time and patience.
Blood values are checked before and after treatment to monitor progress. Most people are able to carry on with their normal daily life after the session. However, it is important to attend appointments regularly, as the effect of apheresis is limited in time and blood fat levels can rise again between sessions.
What concerns are there around lipid apheresis?
Many people wonder whether lipid apheresis is dangerous or whether the procedure can be painful. The treatment is generally well tolerated and is carried out by experienced medical staff. Mild side effects can occur, such as feeling cold, changes in blood pressure, or small bruises at the needle site. Serious complications are rare.
Another concern is the length and frequency of treatment. Because lipid apheresis must be repeated regularly, it does place some demands on everyday life. For many people, however, it is the only way to significantly reduce the risk of further heart attacks or strokes.
The question of whether lipid apheresis will be needed "forever" is also something many people think about. In most cases, the underlying condition, that is the genetic lipid disorder, remains present. This means the treatment must be continued long term, as long as no other effective alternatives are available.
What alternatives or additional measures are there?
Before lipid apheresis begins, there is always an attempt to lower blood fat levels through other measures. These include a diet low in fat, enough physical activity, and medicines such as statins or newer drugs (PCSK9 inhibitors). Only when all of these are not enough or cannot be tolerated does apheresis come into use.
Sometimes additional treatments can help to extend the time between sessions. The treating doctors assess together which options are available in each individual case.
What does life with lipid apheresis look like?
With regular lipid apheresis, the risk of serious damage to blood vessels can be significantly reduced. Many people report feeling more energetic after treatment or having fewer symptoms. Daily life can usually continue as normal, and with a little planning, sport and travel are also possible.
It is important to attend appointments reliably and to follow a heart-healthy lifestyle. The treatment is demanding, but for many people it is the key measure for protecting the heart and blood vessels.
Lipid apheresis is therefore an effective, if rarely used, treatment, above all for people with particularly severe lipid disorders where other measures are not enough.
