2023 - 1 Issue

Review

Rheopheresis and its Use in the Treatment of Diseases with Impaired Microcirculation. A Review

Alena Paříková ORCID

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DOI: 10.31348/2023/1

Published in Czech and Slovak Ophtalmology: 2023 - 1

Published on website: 20.02.2023

Keywords: apheresis, plasmapheresis, rheopheresis, macular degeneration

Summary

Rheopheresis ranks among apheretic methods. It is a selective, extra-corporeal double cascade filtration treatment. First, the plasma is separated from blood elements in extra-corporeal circulation by passing through membrane filter. The plasma is then filtrated through the second filter in order to remove proteins with a high molecular mass, e.g. lipids, fibrinogen, α2-macroglobulin, von Willebrand factor, immunoglobulin IgM. The purified plasma is then returned together with the blood elements back to the patient. The aim of the procedure is to improve the microcirculation and rheological properties of the blood. Rheopheresis is well established method for the treatment of age-related macular degeneration, acute sensorineural hearing loss, calciphylaxis, systemic sclerosis or peripheral vascular disease.

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  7. Thompson GR; HEART-UK LDL Apheresis Working Group. Recommendations for the use of LDL apheresis. Atherosclerosis. 2008 Jun;198(2):247-255. dynamic instability during the procedures outweighs the benefits of treatment. If no impediments are found in any aspect, dates are arranged for the treatment sessions. For the majority of patients, in order to ensure the smooth course of the procedure it was necessary for us to insert a central venous catheter. We use a permanent catheter, which is inserted by our physicians under local anaesthesia on the dialysis unit on the day of the first procedure. The advantage of a permanent catheter is that it does not need replacing after 2–3 weeks as in the case of temporary catheters. After the end of the treatment the catheter is extracted by the surgeons in the operatingroom, due to the necessity of preparing the ingrown dacron cuff into the hypodermis. The catheter is inserted in antibiotic prophylaxis, which is administered to the patient directly be