Effectiveness of a Novel Low-Density Lipoprotein Apheresis Device Rheocarna in Patients Undergoing Hemodialysis With Chronic Limb-Threatening Ischemia: A Single-Center Retrospective Study.

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Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy Pub Date : 2026-08-01 Epub Date: 2026-06-22 DOI:10.1002/1744-9987.70164

Kunihiro Ishioka, Takayasu Ohtake, Kei Ohmori, Chika Shibuya, Tomoki Tsukahara, Mizuki Yamano, Yasuhiro Mochida, Machiko Oka, Kyoko Maesato, Yusuke Tsukamoto, Hidekazu Moriya, Sumi Hidaka, Shuzo Kobayashi

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Abstract

Background: Chronic limb-threatening ischemia (CLTI) is a severe form of lower-extremity artery disease characterized by distal lesions and microcirculatory impairment, limiting revascularization efficacy. Rheocarna is a direct hemoperfusion low-density lipoprotein (LDL) adsorption device with potential rheological and anti-inflammatory benefits. The real-world effectiveness of Rheocarna in patients with advanced CLTI undergoing hemodialysis (HD) remains unclear. This study evaluated clinical outcomes of Rheocarna therapy in patients with CLTI undergoing HD.

Methods: We retrospectively reviewed 31 patients undergoing HD (mean [±SD] age 67 ± 11 years) with CLTI treated with Rheocarna at a single center. Primary outcomes were ulcer healing at 6 months and amputation-free survival (AFS) at 1 year, with baseline characteristics compared between healed and non-healed groups.

Results: At 6 months, the ulcer healing, major amputation, and mortality rates were 25.8%, 35.5%, and 22.6%, respectively. The 1-year AFS rate was 40%. The mean ankle-brachial index significantly improved from 1.00 ± 0.17 to 1.07 ± 0.15 (p = 0.041).

Conclusion: Rheocarna may support wound healing and limb salvage in patients with CLTI undergoing HD; however, its clinical effectiveness appears limited in advanced disease stages.

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一种新型低密度脂蛋白分离装置Rheocarna在慢性肢体缺血血液透析患者中的有效性：一项单中心回顾性研究

背景：慢性肢体威胁缺血（CLTI）是一种严重的下肢动脉疾病，其特征是远端病变和微循环损伤，限制了血运重建的效果。Rheocarna是一种直接血液灌流低密度脂蛋白（LDL）吸附装置，具有潜在的流变学和抗炎益处。Rheocarna在接受血液透析（HD）的晚期CLTI患者中的实际疗效尚不清楚。本研究评估了Rheocarna治疗行HD的CLTI患者的临床结果。方法：我们回顾性分析了31例HD患者（平均[±SD]年龄67±11岁）在单中心使用Rheocarna治疗CLTI。主要结局是6个月溃疡愈合和1年无截肢生存（AFS），并比较愈合组和未愈合组的基线特征。结果：6个月时，溃疡愈合率为25.8%，大截肢率为35.5%，死亡率为22.6%。1年期AFS利率为40%。平均踝肱指数由1.00±0.17显著改善至1.07±0.15 （p = 0.041）。结论：大黄可促进CLTI HD患者的伤口愈合和肢体保留；然而，在疾病晚期，其临床效果似乎有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy

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