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

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.