What is the qualification criteria for ldl apheresis? can pt w/o familial hyperlipidemia genes but high ldl (at 207mg/dl, 90+%), high lipoprotein a (at 84 mg/dl, 89%), strong family hx of ascvd and high polygenic risk for cvd, high ldl,/lps qualify?

No usually need to have LDL greater than 500 and clear diagnosis. Costs a lot to do as well. And no benefit if no REALLY high LDL. The next best is to try the Ornish diet. Then meds if you cant do it or it does not work. Another option if to try Seattle Sutton's Meals lowered mine by 60 mg/dl. If diet is going to work it will work in a month to lower levels to the max. If you follow it.

LDL aphresis is a consideration with these numbers, but only if you are maxed out on medications (statins, PCSK9-inhibitors). So if you are not on these agents, then that is the first step.