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Hi, It’s recommended to do LDL aphaeresis (Liposorber) for patients with high cholesterol and cannot benefit from lipids lowering medications, This procedure is an FDA cleared, and it’s widely used in USA. http://www.liposorber.com/home1.htm Best regards Mohmed Ashmaig Sr. Scientist Berkeley Heart Laboratory USA From: Mohammad Al-Jubouri <[log in to unmask]> To: [log in to unmask] Sent: Monday, 13 June 2011, 8:16 Subject: Re: To Lipidologists Hi Ewan, Is he heterozygous FH? You have no other choice left, Questran or surgery (partial ileal bypass). Regards Mohammad Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath Consultant Chemical Pathologist From:Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Bell Ewan (NHS DUMFRIES & GALLOWAY) Sent: 13 June 2011 15:50 To: [log in to unmask] Subject: To Lipidologists Hi I have a 53 year old male with a cholesterol of 10, normal trigs and HDL. He has hypertension but no vascular history. He has no family history. LFTs, UEs, TFTs all normal with negative ACR. He has been on lowest dose simvastatin, pravastatin, atorvastatin, rosuvastatin, which he can't tolerate due to myositis (indeed on rosuvastatin his CK went up to 1,500). Fibrates and ezetimibe weren't tolerated. Tredaptive was tolerated but didn't work (cholesterol still 10). What do I do next? Thanks for your help, Ewan Dr Ewan Bell Clinical Director - Diagnostics NHS Dumfries and Galloway UK ******************************************************************************************************************** This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Thank you for your co-operation. 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