 Homozygous familial hypercholesterolemia HoFH is characterized by a six- to eight-fold raise in plasma LDL-cholesterol LDL-C concentrations and atherosclerotic coronary artery disease usually occur before the age of 20 if untreated. Lipid apheresis LA has been proved to be a reliable method to decrease LDL-C concentrations and therefore decrease cardiovascular disease risk in HoFH. The objective of this crossover study was to compare efficacy of LA performed with heparin-induced extracorporeal LDL precipitation to dextran sulfate adsorption on the reduction of lipids, inflammatory markers, adhesion molecules and LDL particles size in a cohort of HoFH subjects. 