The extracorporeal procedure for the specific removal of lipoprotein (a) (Lp(a)) from human plasma--Lp(a) apheresis--was applied to the treatment of three patients with coronary artery disease documented by angiography. Their initial lipid levels were as follows: total cholesterol, 210-230 mg/dl; low-density lipoprotein (LDL) cholesterol, 140-160 mg/dl; Lp(a), 90-120 mg/dl. The patients underwent a total of 168 procedures without significant side effects. Lp(a) apheresis reduced the Lp(a) level by removing up to 88% of Lp(a). Other plasma compounds, including LDL and plasminogen, remained practically unchanged. Lp(a) apheresis appears to be a unique, effective and specific method for lowering the Lp(a) level. Additional trials are needed to evaluate the clinical effect of this treatment.