The three established methods for low-density lipoprotein (LDL) apheresis, LDL immunoabsorption, dextran sulfate cellulose-LDL apheresis and heparin-induced extracorporeal LDL precipitation (HELP)-LDL apheresis, are equally safe and effective. Hemorrheological parameters are also improved by these procedures, notably by HELP-LDL apheresis which also eliminates fibrinogen from plasma. Preliminary data suggest that LDL apheresis may be an important tool for primary and secondary prevention in selected patients with a particularly high risk for coronary heart disease