Extracorporeal fibrinogen adsorption – efficacy, selectivity and safety in healthy subjects and patients with foot ulcers

Richter, Werner; Schneidewind, J.M; Ramlow, Wolfgang; Jahn, P.; Jung, Norbert; Nielebock, Evelyn; Tachezy, H; Eulitz, Klaus; Koll, Robert; Klinkmann, J.

doi:10.1016/s1473-0502(01)00140-9

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…Recently, the results of a pilot study using a fibrinogen adsorber to decrease fibrinogen levels over a period of 28 days by repetitive treatments every 2–3 days were published (39). A mean pretreatment decrease in fibrinogen levels of 45% was observed in 10 patients with diabetic foot ulcers after 6–26 treatments.…”

Section: Discussionmentioning

confidence: 99%

Rheopheresis in Patients with Ischemic Diabetic Foot Syndrome: Results of an Open Label Prospective Pilot Trial

et al. 2003

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Rheopheresis is a specific application of membrane differential filtration, synonymous with double filtration plasmapheresis, for extracorporeal hemorheotherapy. Safety and efficacy of Rheopheresis for wound healing and skin oxygenation were investigated in patients with ischemic diabetic foot syndrome. Eight patients with type 2 diabetes mellitus and non-healing foot ulcers caused by severe ischemic diabetic foot syndrome were treated by a series of seven Rheopheresis sessions in a time span of 11 weeks. Wound healing had not been detectable under conditions of standardized wound care during at least 2 months. Wound status was classified by its morphology, severity and location, according to the criteria of Wagner. Transcutaneous oxygen pressure (tcPO2), laser Doppler flowmetry and vital capillary microscopy were repeatedly performed to monitor the effects of the Rheopheresis treatment series on microcirculation and skin blood flow. Laboratory parameters of blood rheology, endothelial function and inflammatory state were measured in addition to safety parameters. In four patients (baseline Wagner stage 2), Rheopheresis accelerated wound healing of foot ulcers and was associated with an improvement of Wagner stage and a pronounced increase in tcPO2. In two patients (baseline Wagner stage 2), wound healing was unchanged but mean tcPO2 increased, allowing successful minor amputation. Values of tcPO2 remained stable and enhanced for the 3 months follow-up period. In two patients (baseline Wagner stage 4 or 5), no improvements in foot lesions were observed within the treatment period. As an adjunct therapeutic option, Rheopheresis may preserve a functional lower extremity, delay amputation or reduce the extent of amputation.

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Section: Discussionmentioning

confidence: 99%

Rheopheresis in Patients with Ischemic Diabetic Foot Syndrome: Results of an Open Label Prospective Pilot Trial

et al. 2003

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“…Methods of direct extracorporeal adsorption of fibrinogen and lipoprotein are also used [ 124 - 126 ]. Methods of cascade plasmapheresis are also perspective, given its greater efficiency and selectivity [ 127 ].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Apheresis in Metabolic Syndrome

Voinov

2018

IEMAMC

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Background:The metabolic syndrome unites three pathologies of the person – obesity, arterial hypertension and diabetes. In recent years the progressing of such distribution covering from 2.5% to 3.8% of the population with increase twice each 10-15 years is noted. Even at maintenance of level of sugar at diabetes accumulation of the secondary metabolites breaking small vessels isn't excluded. At the same time many life-endangering complications develop.Objective:To identify the possibilities of plasmapheresis in the prevention and treatment of complications of metabolic syndrome.Method:Analysis of the world literature data on complications of metabolic syndrome and methods of their treatment.Results:At metabolic syndrome the frequency of strokes and myocardial infarctions there is twice more often than in population. For 5-9 years the general life expectancy decreases. Disorders of microcirculation at diabetes lead to a retinopathy with total loss of sight, a nephropathy from the outcome in a renal failure, to polyneuropathy and diabetic foot syndrome with high risk of high level amputations of the lower extremities. At the same time medicamentous therapy is not able to prevent such complications and almost only way of removal of these pathological metabolites is therapeutic apheresis, mainly the plasmapheresis. Data from our own studies confirm the effectiveness of such tactics.Conclusion:Plasmapheresis has to be applied not only to the correction of already critical conditions, but also to their prevention.

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“…Accordingly, 200 mgdL was considered the minimal difference to be detected. Standard deviations of 183.7 [18] and 205 mg/dL [20] have been found, therefore, we estimated a value of 194. a ¼ 0, 05 and b ¼ 0, 95 were considered. The need to treat patients was calculated as 20/treatment group but 48 patients (24/treatment group) were enrolled in the study taking in account the possibility of missing data.…”

Section: Methodsmentioning

confidence: 99%

“…A mean fibrinogen concentration of 619 mg/dL has been found in patients with diabetic foot [20]. It has been suggested the need that fibrinogen measurements deviate over one third the value of its mean in order to be considered statistically different [27].…”

Section: Methodsmentioning

confidence: 99%

De Marco Formula effectiveness as an adjunctive therapy to prevent infected ischemic diabetic foot amputation and reduce plasma fibrinogen

Mesa¹,

Duarte²,

Carretero³

et al. 2011

Journal of Tissue Viability

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Extracorporeal fibrinogen adsorption – efficacy, selectivity and safety in healthy subjects and patients with foot ulcers

Cited by 8 publications

References 25 publications

Rheopheresis in Patients with Ischemic Diabetic Foot Syndrome: Results of an Open Label Prospective Pilot Trial

Rheopheresis in Patients with Ischemic Diabetic Foot Syndrome: Results of an Open Label Prospective Pilot Trial

Therapeutic Apheresis in Metabolic Syndrome

De Marco Formula effectiveness as an adjunctive therapy to prevent infected ischemic diabetic foot amputation and reduce plasma fibrinogen

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