Document Detail


Heparin-induced Extracorporal LDL precipitation (H.E.L.P) in diabetic foot syndrome - preventive and regenerative potential?
MedLine Citation:
PMID:  18622889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Peripheral arterial disease is more aggressive in concomitant diabetes posing an increased risk for critical limb ischemia and subsequent limb loss. The majority of therapies available are not effective to prevent amputation in patients with severe disease. The current observational study reports the effect of the heparin-induced extracorporal LDL-precipitation (H.E.L.P.) as a novel therapeutic approach in patients with severe diabetic foot syndrome. Seventeen diabetic patients with septic foot lesions recruited from the diabetic outpatient clinic underwent H.E.L.P. apheresis regularly until fibrinogen levels were stabilized at 3 g/l or infection was controllable as evidenced by alleviation of necrosis. Patients were subsequently followed up for 2 to 73 months. Fibrinogen levels were reduced by 68% after H.E.L.P. treatment. No severe complications were noted. Necrosis could be confined in sixteen patients. Minor amputations were indicated in twelve patients. Three patients underwent major amputations of the lower limb and two patients received surgical reconstruction. In conclusion, H.E.L.P. apheresis may offer an alternative therapeutic option to diabetic patients with critically ischemic feet and appears to have a beneficial major/minor amputation ratio.
Authors:
H Rietzsch; I Panzner; T Selisko; U Julius; N Jabs; M Reimann; E Bonifacio; M Bornhäuser; S R Bornstein
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme     Volume:  40     ISSN:  0018-5043     ISO Abbreviation:  Horm. Metab. Res.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-14     Completed Date:  2008-10-06     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0177722     Medline TA:  Horm Metab Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  487-90     Citation Subset:  IM    
Affiliation:
Technical University of Dresden, Department of Medicine III.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amputation / rehabilitation
Blood Component Removal / methods*
Blood Viscosity / physiology
Chemical Precipitation
Diabetic Foot / physiopathology,  therapy*
Extracorporeal Circulation* / methods
Female
Heparin / pharmacology*
Humans
Limb Salvage / methods*
Lipoproteins, LDL / drug effects,  metabolism*
Male
Middle Aged
Wound Healing / physiology*
Chemical
Reg. No./Substance:
0/Lipoproteins, LDL; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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