The extracorporeal elimination of LDL-cholesterol was performed by using a classical non-selective centrifuge or membrane plasmapheresis. Modern methods are more selective and effecti ve. The atherogenic particles are removed from plasma by an active column or capsule. The methods include: cascade filtration, immunoadsorption, heparinnduced precipitation of LDL, thermofiltration, dextran-induced precipitation of LDL and direct adsorption of lipids (DALI). Regular LDL-apheresis is a life-saving technique in the treatment of homozygous familial hypercholesterolaemia. It is used in heterozygous familial hypercholesterolaemia when the patients do not respond to diet and drug therapy. Regular LDL-apheresis treatment may be followed by a decreased frequency of angina pain episodes, reduction of ECG changes during bicycle ergometry and significant disappearance of tendinous xanthomas. Some prospective randomised studies have shown even in this group of patients, resistant to conventional treatment, a significant regression of atherosclerotic changes.

        Key words: LDL-apheresis, immunoadsorption, familial hypercholesterolaemia