{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:42:07Z","timestamp":1789429327431,"version":"build-2803163510"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012320","name":"Otto-von-Guericke-Universit\u00e4t Magdeburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012320","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chirurgie"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Aktuell ist eine Zunahme der schweren Stadien der peripheren arteriellen Verschlusskrankheit (pAVK) mit kritischer Isch\u00e4mie zu verzeichnen. Dies scheint sowohl dem allgemeinen demographischen Wandel zu entsprechen als auch eine Folge der SARS-CoV-2(\u201esevere acute respiratory syndrome coronavirus 2\u201c)-Pandemie der letzten 3\u00a0Jahre zu sein. Das mittlerweile etablierte und akzeptierte interventionelle\/endovaskul\u00e4re Vorgehen bei einer schweren Unterschenkel-pAVK in erfahrener Hand gilt nach wie vor als \u201eFirst-line\u201c-Therapie, jedoch erlebt aus eigener Sicht der krurale\/pedale Venenbypass eine Renaissance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material und Methoden<\/jats:title>\n                <jats:p>Kompakte narrative \u00dcbersicht \u00fcber den aktuellen Stand der kruralen\/pedalen Bypasschirurgie in Deutschland und Sachsen-Anhalt (SA), kombiniert mit selektiven Referenzen der aktuellen wissenschaftlich-medizinischen Literatur und eigenen klinischen Erfahrungen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Eine aktuelle Statistik der fallbezogenen DRG(\u201ediagnosis related groups\u201c)-Daten zeigt, dass insbesondere mit Auftreten der Corona-Pandemie ein R\u00fcckgang der station\u00e4ren Fallzahlen von Patienten mit einem pAVK-Stadium IIB bundesweit und ebenfalls im Bundesland SA zu verzeichnen ist. Die schweren pAVK-Stadien blieben in den Fallzahlen ann\u00e4hernd gleich, in SA jedoch zunehmend. Die WIFI-Klassifikation bietet die M\u00f6glichkeit, \u00fcber ein Punktesystem Aussagen \u00fcber das Amputationsrisiko, Nutzen und Art der Revaskularisationsma\u00dfnahme erstellen zu k\u00f6nnen. Verschlussl\u00e4nge, Verschlusslokalisation der betroffenen Gef\u00e4\u00dfe und Verkalkungsgrad finden Ber\u00fccksichtigung im Global-Limb-Anatomic-Staging-System (GLASS) zur Beurteilung der Prognose. Die Auswertung der Fallpauschalenbezogenen Krankenhausstatistik von 2015 bis 2020 ergab eine konstante Anwendung der femorokruralen\/-pedalen Bypasschirurgie in Deutschland sowie eine leichte Zunahme der Rekonstruktion mittels femorokruraler Byp\u00e4sse in SA, die mit dem tendenziellen Fallzahlenanstieg der schweren pAVK zu korrelieren scheint.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Schlussfolgerung<\/jats:title>\n                <jats:p>Zur Indikationsstellung f\u00fcr die Anlage eines kruralen\/pedalen Bypasses sollte die parameterbasierte Objektivierung des Schweregrades der kritischen Extremit\u00e4tenisch\u00e4mie mit einbezogen werden. Daf\u00fcr eignen sich die WIFI-Klassifikation und GLASS, da hier auch eine relative Erfolgsprognose m\u00f6glich ist. Die Behandlung der kritischen Extremit\u00e4tenisch\u00e4mie mittels kruraler\/pedaler Bypasschirurgie findet in Deutschland und SA nach wie vor eine konstante Anwendung.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00104-023-01933-7","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T10:02:42Z","timestamp":1692784962000},"page":"861-869","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Aktualit\u00e4t der grundlegenden und determinierenden Bedeutung der chronisch-kritischen Extremit\u00e4tenisch\u00e4mie sowie ihrer sich reetablierenden Behandlung mittels kruraler\/pedaler Byp\u00e4sse in Deutschland und in Sachsen-Anhalt","Topicality of the fundamental and determining importance of chronic critical ischemia of the extremities and its restorative treatment using crural\/pedal bypasses in Germany and in Saxony-Anhalt"],"prefix":"10.1007","volume":"94","author":[{"given":"Udo","family":"Barth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Halloul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"issue":"6","key":"1933_CR1","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1007\/s00772-019-00557-8","volume":"24","author":"H B\u00f6hner","year":"2019","unstructured":"B\u00f6hner\u00a0H, Nowak\u00a0T, Geier\u00a0B, Pourhassan\u00a0S (2019) Therapie der peripheren arteriellen Verschlusserkrankung im Stadium\u00a0II aus Sicht von Patient, Arzt und \u00d6konom. 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