| Heparin-induced Extracorporal LDL precipitation (H.E.L.P) in diabetic foot syndrome - preventive and regenerative potential? | |
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MedLine Citation:
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PMID: 18622889 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2008-07-14 Completed Date: 2008-10-06 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 0177722 Medline TA: Horm Metab Res Country: Germany |
Other Details:
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Languages: eng Pagination: 487-90 Citation Subset: IM |
Affiliation:
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Technical University of Dresden, Department of Medicine III. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Lipoproteins, LDL; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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