{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:25:07Z","timestamp":1782181507312,"version":"3.54.5"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n          Allgemeine Prinzipien\u2002Arterielle Durchblutungsst\u00f6rungen der oberen Extremit\u00e4ten wurden lange vernachl\u00e4ssigt. Die 2017 erschienene ESC-Leitlinie zur Diagnostik und Therapie der peripheren arteriellen Verschlusskrankheit (pAVK) widmet als erste Leitlinie einen eigenen Abschnitt den oberen Extremit\u00e4ten 1\n          2. Damit r\u00fccken die vergleichsweise seltenen arteriellen Durchblutungsst\u00f6rungen von Armen und H\u00e4nden st\u00e4rker in das medizinische Bewusstsein. Die Diagnostik und Therapie der zugrunde liegenden, \u00e4tiologisch sehr heterogenen Krankheitsbilder erfordern ein breites gef\u00e4\u00dfmedizinisches Wissen und einen differenzierten Einsatz des gesamten Spektrums vaskul\u00e4rer Untersuchungstechniken und Behandlungsmethoden.<\/jats:p><jats:p>\n          Die wichtigsten Krankheitsbilder\u2002Die h\u00e4ufigste Manifestation der Arteriosklerose der oberen Extremit\u00e4t ist die Subklaviastenose. Die Behandlung ist meist konservativ. Bei klinischer Indikation stehen endovaskul\u00e4re Therapieoptionen zur Verf\u00fcgung. Eine h\u00e4ufige Manifestation der Gro\u00dfgef\u00e4\u00dfvaskulitis sind Stenosen der A. subclavia und A. axillaris. Durch die Einf\u00fchrung der TNT\u03b1-Blocker und des IL-6-Antagonisten Tocilizumab hat die Behandlung der Gro\u00dfgef\u00e4\u00dfvaskulitis gro\u00dfe Fortschritte erlebt. Das Thoracic-outlet-Syndrom ist diagnostisch eine Herausforderung. Da es zu schweren Durchblutungsst\u00f6rungen des Arms f\u00fchren kann, ist die gezielte Diagnostik (klinische Untersuchung und Bildgebung) zum Ausschluss von Differenzialdiagnosen wichtig. Das prim\u00e4re Raynaud-Ph\u00e4nomen ist Ausdruck einer gutartigen, reversiblen, vasospastischen Hyperreagibilit\u00e4t der Fingerarterien im Gegensatz zum sekund\u00e4ren Raynaud-Ph\u00e4nomen mit meist schwerem Verlauf. Ziel der Diagnostik ist das fr\u00fchzeitige Erkennen sekund\u00e4rer Formen des Raynaud-Ph\u00e4nomens.<\/jats:p>","DOI":"10.1055\/a-1068-4230","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T22:40:46Z","timestamp":1602024046000},"page":"1437-1442","source":"Crossref","is-referenced-by-count":3,"title":["Durchblutungsst\u00f6rungen der oberen Extremit\u00e4ten"],"prefix":"10.1055","volume":"145","author":[{"given":"Federico","family":"Tat\u00f2","sequence":"additional","affiliation":[{"name":"Gef\u00e4\u00dfpraxis im Tal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,10,6]]},"reference":[{"key":"ref1","first-page":"783","article-title":"2017 ESC Guidelines on the diagnosis and treatment of peripheral artery diseases, in collaboration with the European Society of Vascular Surgery (ESVS)","volume":"39","year":"2018","journal-title":"Eur Heart J"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780198784906.003.0779","volume-title":"Upper extremity artery disease","author":"T Cohnert","year":"2018","edition":"3rd ed"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/1358863X10384174","article-title":"Subclavian artery stenosis: a review for the vascular practitioner","volume":"16","author":"V M Ochoa","year":"2010","journal-title":"Vasc Med"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1177\/0003319717725966","article-title":"Upper extremity medial arterial calcification and peripheral artery disease in asymptomatic patients with chronic kidney disease in predialysis stage","volume":"69","author":"K Viskovic","year":"2018","journal-title":"Angiology"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1177\/1526602816659279","article-title":"Outcomes of endovascular therapy for upper extremity peripheral artery disease with critical hand ischemia","volume":"23","author":"Y Tomoi","year":"2016","journal-title":"J Endovasc Ther"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1177\/1358863x07085499","article-title":"Giant cell arteritis: a systemic vascular disease","volume":"13","author":"F Tat\u00f2","year":"2008","journal-title":"Vasc Med"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1093\/rheumatology\/kex424","article-title":"Large-vessel giant cell arteritis: diagnosis, monitoring and management","volume":"57","author":"J M Koster","year":"2018","journal-title":"Rheumatology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1055\/s-0043-114848","article-title":"Neues zur Diagnostik und Therapie der Riesenzellarteriitis","volume":"143","author":"M Czihal","year":"2018","journal-title":"Dtsch Med Wochenschr"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1002\/art.20922","article-title":"Itaka Study Group. 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