LDL apheresis (LA), a technique employed to remove atherogenic lipoproteins, has been shown to exert a protective function on the vessel walls. This effect can be attributed to pleiotropic mechanisms that safeguard against endothelial dysfunction by reducing the concentrations of pro-inflammatory and pro-coagulation markers. Besides these actions, LA improves whole blood viscosity and endothelium-mediated vasodilation, and has a positive effect on the hemorheological picture, improving perfusion in the microcirculation. Although the short term effects on the functional component of the vascular damage seem to be temporary, long term effects on the morphological alterations have also been shown. It is still not clear which of the many proposed actions, or others still to be discovered, is the principal vessel protective mechanism.
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