Introduction: Dyslipidemia, along with the oxidative deterioration of the lipoproteins, generate a pathological coronarian status with hyperreactivity (spasm) plaque disruption, NO resistance, an inflammatory biochemical syndrome (CRP elevation, hyperinosis etc.). Lipidplasmapheresis is able to promptly revert all these parameters Methods: Review of the literature and presentation of four cases. Results: No risks, no incidents. Prompt improvement of clinical status of the patients that became asymptomatic. Conclusions: Lipidplasmapheresis, rarely used in Romania, could be considered very useful in the management of acute coronary insuffi ciency in severe dyslipidemic patients unable to be subjected to invasive procedure, in pregnant women and in the case of statine intolerance.