Peripheral Artery Disease Management Open access Peer reviewed

Effectiveness of a Novel Low‐Density Lipoprotein Apheresis Device Rheocarna in Patients Undergoing Hemodialysis With Chronic Limb‐Threatening Ischemia: A Single‐Center Retrospective Study

Kunihiro Ishioka, Takayasu Ohtake, Kei Ohmori, Chika Shibuya and 9 more

Therapeutic Apheresis and Dialysis | Jun 22, 2026

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Rheocarna may support wound healing and limb salvage in patients with CLTI undergoing hemodialysis; however, its clinical effectiveness appears limited in advanced disease stages.

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BACKGROUND: Chronic limb-threatening ischemia (CLTI) is a severe form of lower-extremity artery disease characterized by distal lesions and microcirculatory impairment, limiting revascularization efficacy. Rheocarna is a direct hemoperfusion low-density lipoprotein (LDL) adsorption device with potential rheological and anti-inflammatory benefits. The real-world effectiveness of Rheocarna in patients with advanced CLTI undergoing hemodialysis (HD) remains unclear. This study evaluated clinical outcomes of Rheocarna therapy in patients with CLTI undergoing HD. METHODS: We retrospectively reviewed 31 patients undergoing HD (mean [±SD] age 67 ± 11 years) with CLTI treated with Rheocarna at a single center. Primary outcomes were ulcer healing at 6 months and amputation-free survival (AFS) at 1 year, with baseline characteristics compared between healed and non-healed groups. RESULTS: At 6 months, the ulcer healing, major amputation, and mortality rates were 25.8%, 35.5%, and 22.6%, respectively. The 1-year AFS rate was 40%. The mean ankle-brachial index significantly improved from 1.00 ± 0.17 to 1.07 ± 0.15 (p = 0.041). CONCLUSION: Rheocarna may support wound healing and limb salvage in patients with CLTI undergoing HD; however, its clinical effectiveness appears limited in advanced disease stages.

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Kunihiro Ishioka

first | Shonan Kamakura General Hospital | ORCID 0000-0001-9129-5075

Takayasu Ohtake

middle | Shonan Kamakura General Hospital | ORCID 0000-0002-7009-161X

Kei Ohmori

middle | Shonan Kamakura General Hospital

Chika Shibuya

middle | Shonan Kamakura General Hospital

Tomoki Tsukahara

middle | Shonan Kamakura General Hospital

Mizuki Yamano

middle | Shonan Kamakura General Hospital

Yasuhiro Mochida

middle | Shonan Kamakura General Hospital

Machiko Oka

middle | Shonan Kamakura General Hospital

Kyoko Maesato

middle | Shonan Kamakura General Hospital

Yusuke Tsukamoto

middle | Shonan Kamakura General Hospital | ORCID 0000-0002-3089-2287

Hidekazu Moriya

middle | Shonan Kamakura General Hospital | ORCID 0000-0002-3252-2976

Sumi Hidaka

middle | Shonan Kamakura General Hospital | ORCID 0000-0002-1576-0868

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BibTeX

@article{Ishioka2026Effectiveness,
  title = {Effectiveness of a Novel Low‐Density Lipoprotein Apheresis Device Rheocarna in Patients Undergoing Hemodialysis With Chronic Limb‐Threatening Ischemia: A Single‐Center Retrospective Study},
  author = {Kunihiro Ishioka and Takayasu Ohtake and Kei Ohmori and Chika Shibuya and Tomoki Tsukahara and Mizuki Yamano and Yasuhiro Mochida and Machiko Oka and Kyoko Maesato and Yusuke Tsukamoto and Hidekazu Moriya and Sumi Hidaka and Shuzo Kobayashi},
  journal = {Therapeutic Apheresis and Dialysis},
  year = {2026},
  doi = {10.1002/1744-9987.70164},
  url = {https://doi.org/10.1002/1744-9987.70164}
}

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