Frequently asked questions

It is a blood-filtering therapy, closely related to dialysis. Your blood passes through a machine that selectively removes lipoprotein(a), LDL, and ApoB, the cholesterol particles that build plaque in your arteries, and then returns the cleaned blood to you.

Statins reduce how much cholesterol your body produces. Apheresis physically removes what is already circulating. That is why the effect is immediate, and why it works for Lp(a), which statins barely touch.

Yes. It is FDA-approved for patients who meet the indicated criteria, and it has been used clinically for decades in the United States and Europe.

Those criteria are specific. They depend on whether your high cholesterol is inherited, on your LDL and Lp(a) numbers, and on whether you have documented coronary or peripheral artery disease. We confirm that you meet them before you begin. It is part of the candidacy review at your consultation.

A single session removes roughly 65–85% of circulating Lp(a), LDL, and ApoB.

Levels rebuild between sessions, which is why treatment is repeated on a regular schedule, typically every one to two weeks. What matters is your average level over months and years, not the number on any single day.

No. It is ongoing therapy, not a cure. Your body continues producing these particles at the rate your genetics dictate. Regular treatment keeps your average exposure much lower over time, and it is that cumulative exposure that drives cardiac risk.

The IV placement is a brief pinch, similar to giving blood. The treatment itself is not painful. Most patients describe the session as uneventful, and many nap through it.

Two to four hours in the chair, plus about 30 minutes for check-in and observation. Plan on roughly four hours door to door, especially for your first visit.

Most patients are treated every one to two weeks on an ongoing basis. Your exact schedule depends on your labs and your cardiologist's guidance.

Most sessions are uneventful. The effects patients report most often are lightheadedness, a temporary drop in blood pressure, and bruising or tenderness at the IV site.

Important: ACE inhibitors, a widely prescribed class of blood-pressure medication, cannot be taken alongside this treatment. Combined with the columns we use, they can cause a serious reaction. This is manageable and routine: we work with your physician to switch you to an alternative such as an ARB, and there is a washout period before you begin. Bring your complete medication list to your consultation so we can sort this out well ahead of your first session.

Many patients do. Because blood pressure can dip during a session, we check you before you leave and we would rather be cautious after your first treatment, so plan to have someone available to drive you that first time.

Yes, and we encourage it. Have a normal meal and drink plenty of water beforehand; both make the session more comfortable.

Most patients are treated through a small IV in each arm: one to draw blood out, one to return it. That means your arms need to stay reasonably still. Typing on a laptop is awkward, but reading on a propped tablet, watching something, listening to a podcast, or sleeping all work well. We have Wi-Fi, screens, headphones, and blankets.

If your veins make that difficult, or you already have a port, a central catheter or a dialysis fistula, we can use that instead. If you are treated that way, you will usually have more freedom to move your hands.

Documented peripheral artery disease is part of the approved criteria, but alongside a cholesterol condition, not on its own. If you have heterozygous familial hypercholesterolemia with documented PAD and an LDL-C of 70 mg/dL or above, or an Lp(a) of 60 mg/dL or above, you fall within the indicated groups once diet and maximum medication have not been enough.

PAD by itself, in someone without inherited high cholesterol or elevated Lp(a), is not an approved use. That is the group the research is still exploring.

This is why we ask about your Lp(a) early. It often decides which conversation we are having.

We cannot promise that. Surgeons at Cedars-Sinai reported a patient with a non-healing foot wound, not a candidate for bypass, whose wound closed completely over twelve weeks of apheresis combined with routine wound care, and stayed healed at three months.

That is one patient. A single case shows something is possible; it cannot tell you how likely it is, and because wound care was given at the same time, the closure cannot be credited to apheresis alone.

The larger PAD study measured blood flow and quality of life rather than wound healing, so it does not answer this question either. We would rather say that plainly than imply more than the evidence supports.

That is exactly the situation this research is about, what is sometimes called "no-option" PAD. Apheresis is not a substitute for revascularization, and it does not reopen a blocked artery.

What it may do is improve flow through the smallest vessels, which is where a wound gets its blood supply. Call us and we will go through your labs and history with you, and tell you honestly whether we think it is worth pursuing.

Candidacy is based on your LDL or Lp(a) level, your cardiovascular history, and documentation that maximum medical therapy has not been enough. We review your labs and records and give you a straight answer at consultation.

Not to start the conversation. Call us directly and we will review your situation. If you move forward with treatment, we coordinate with your cardiologist and primary physician.

Medicare and many commercial plans cover lipoprotein apheresis for patients who meet established criteria. We verify your benefits and handle prior authorization before you begin, so you know your costs up front.

We will tell you plainly and explain why, and we will point you toward the options that make sense for your situation, including newer medications that may be appropriate.

Most patients go from first call to first session within a few weeks. The timeline depends mainly on gathering records and insurance authorization.