The POSCH study reduced blood cholesterol by about 1.8 mmol per litre using partial ileal bypass surgery. This reduction was reliably maintained for ten years, and after the first few years, there was a reduction by about 30% of risk of events. There was also a large reduction in the need for CABG - two and a half fold, which would be potentially very cost effective.
However, since comparable reductions in total cholesterol levels can now be achieved with HMG CoA reductase inhibitors, it is unlikely that surgery will be used extensively for the management of hypercholesterolaemia.
- evine GN et al (1995). Cholesterol reduction in cardiovascular disease. NEJM, 332, 512-20.
Last reviewed 01/2018