Cascade plasmofiltration

Cascade plasmofiltration – highly selective, effective extracorporeal method of blood purification, which is based on the removal of blood components with high molecular weight.

During the procedure, plasma obtained by means of a centrifuge separator is passed through the filter membrane, where, in turn, there is separation and removal of atherogenic lipoproteins of low and very low density (LDL and VLDLa), lipoprotein-A (LP (a)), circulating immune complexes, triglycerides, fibrinogen and its decomposition products, Willebrant factor, fibronectin, C1 and C3-components of the Complement System, etc. macromolecules. The technique is also used to prevent repeated vascular stenosis in patients who have undergone aorto-coronary bypass surgery (CABG) or coronary stenting.

CPF (cascade plasmofiltration) is performed on a blood cell separator with a set of highways and with the inclusion of a plasma filter in the circuit.
Plasma passing through the plasma filter was divided into concentrate, which contains macromolecules larger than that of IgG (including LDL, LP (a), triglycerides, fibrinogen), and plzmofiltrate, which contains all other components of smaller blood plasma (HDL, IgG), along with red blood cells, and return to the patient’s vascular bed. If it is necessary to remove plasma components with a lower molecular weight, it is possible to use a filter with a smaller pore diameter. In one procedure, 300-400 ml of concentrate is removed from 3-4 liters of filtrate, which is replaced with a balanced saline solution.

CPF, according to North American Scientists and European Studies, leads to a decrease in the concentration of total cholesterol by an average of 67%, LDL by 72%, LP (a) by 70%, triglycerides by 54%, KGDG by 30%, fibrinogen by 63%, plasma viscosity by 16%.

 

Indications for cascade plasmofiltration in lipid metabolism disorders:

• Homozygous form of hereditary hypercholesterolemia (absolute indications)
• Heterozygous form of hereditary hypercholesterolemia-severe course, lack of effect from drug therapy and / or intolerance to lipid-lowering drugs
• Combined hyperlipidemia
• Presence of CHD and high levels of LP (α)
• Insufficient effect or inability to use lipid-lowering therapy in patients with primary or secondary hyperlipidemia
• Lipid metabolism disorders in patients undergoing angioplasty
• Severe hyperviscosity in case of exacerbation of CHD

 

Therapeutic effect of CPF:

• Restoration of blood rheology (reduction of viscosity)
• Improved microcirculation
• Normalization of vascular endothelial functions, red blood cells, and platelets
• Increased tissue oxygenation
• Increased sensitivity to medications
• Correction and reduction to target values of lipid factors CHD

 

Advantages of cascade plasmofiltration:

• Selective removal of pathogenic plasma components depending on molecular size
• Components such as autoalbumin, blood clotting factors are returned to the patient’s bloodstream
• Reducing the volume or completely eliminating the use of plasma-substituting solutions
• Safety of plasma exchange (by reducing the risk of transfusiological infections)

According to the results of large epidemiological studies conducted : Framingham, MRFIT ( Multiple Risk Factor Intervention Trial ), SCS ( Seven Countries Study), a clear correlation was found between the concentration of cholesterol in the blood and the mortality rate from CHD.

 

Lowering normal or elevated blood cholesterol levels has been shown to reduce:

• Frequency of myocardial infarctions by 26-37%
• Mortality from cardiovascular diseases-by 28-42 %
• Total mortality-by 22-30%
• The need for surgical and endovascular revascularization of the myocardium-by 27-37%