Reopening of internal carotid artery occlusions during heparin-induced LDL precipitation (H.E.L.P.) associated with improved haemorheology: report of 2 cases.

As has already been reported, there is a direct relationship between the severity of cerebrovascular insufficiency and elevated plasma fibrinogen levels, as well as whole blood and plasma viscosity, Red Cell Transit Time (RCTT) and cerebral blood flow. By applying heparin-induced extracorporeal LDL < cholesterol, triglycerides, fibrinogen > precipitation (H.E.L.P.), a rapid reduction of fibrinogen has become possible which has proved to be very beneficial for the treatment of acute stroke and multi-infarct disease. The present report demonstrates the impact of H.E.L.P. in connection with Doppler and Duplex sonography: In one patient a complete occlusion at the origin of the right internal carotid artery was revealed by Doppler and Duplex sonography. In a second patient, a complete occlusion of the left internal carotid artery was verified. By applying H.E.L.P. once a week (seven times in patient #1, twelve times in patient #2), a consistent lowering of fibrinogen, whole blood and plasma viscosity, red cell transit time, total cholesterol, low density lipoprotein, lipoprotein (a) and triglycerides was achieved. After H.E.L.P. application, Doppler/Duplex sonography showed complete reopening of the previously occluded vessel in patient #1 and patency of the vessel of patient #2.