Effectiveness of the cascade filtration technique in the management of inoperable leg ischemia

Background: This study aims to investigate the effectiveness of the cascade filtration technique in individuals with peripheral vascular disease who are candidates for amputation. Methods: Twelve patients (9 males, 3 females; mean age 62.4 +/- 7.2 years; range 45 to 75 years) were included in the study. For the evaluation of the efficacy of this procedure, measurements of serum albumin, fibrinogen, immunoglobulin M, alpha-2 macroglobulin, low density lipoprotein (LDL) cholesterol, fibronectin, von Willebrand factor levels, blood viscosity, and transcutaneous oxygen saturation (tcPO(2)) were obtained before and after the procedure at sessions 1, 4, and 7. Results: A statistically insignificant increase in tcPO(2) values and a significant decrease in viscosity were determined (p=0.019). Fibronectin, von Willebrand factor, and viscosity levels were significantly decreased at the end of protocol, compared to baseline values. Various degrees of improvement were noted in seven of the 10 patients. After the completion of the protocol, amputation from a more distal level than previously planned was performed in three patients. Conclusion: Cascade filtration, despite its high cost, appears to be an effective treatment alternative which limits or prevents amputation.