{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T06:27:10Z","timestamp":1778135230298,"version":"3.51.4"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n            Aktuelle Studiendaten Die randomisierte Disrupt-III-Studie verglich die intravaskul\u00e4re Lithotrypsie verkalkter Plaques zur L\u00e4sionsvorbereitung vor medikamentenbeschichteter Ballon-Angioplastie (DCB) mit einer Vordilatation mit einem herk\u00f6mmlichen Ballon. Die einarmige REALITY-Studie untersuchte die direktionale Atherektomie zur L\u00e4sionsvorbereitung vor DCB-Angioplastie. Beide Studien zeigten, dass sich auch schwer verkalkte Stenosen und Verschl\u00fcsse der femoropoplitealen Arterie bis zu 30cm L\u00e4nge erfolgreich mit einer geringen Stent-Implantationsrate behandeln lassen. Dies ist von besonderer Bedeutung, da sich in einer multivariaten Analyse eine Residualstenose &gt; 30% nach DCB-Angioplastie als einziger unabh\u00e4ngiger Risikofaktor f\u00fcr eine Restenose erwiesen hat. Der potenzielle Nutzen der Lithotrypsie wurde auch in einer Studie an Zugangsarterien, die f\u00fcr die transfemorale Implantation von Aortenklappenprothesen ben\u00f6tigt werden, mit einer hohen Erfolgs- und niedrigen Komplikationsrate untersucht.<\/jats:p><jats:p>\n            Technisches Verfahren zur Behandlung verkalkter Plaques: Intravaskul\u00e4re Lithotrypsie (IVL) Die intravaskul\u00e4re Lithotrypsie ist eine neue Katheter-Technologie. Dabei wird \u00fcber einen in der Stenose inflatierten Ballon-Katheter durch die Emission pulsatiler akustischer Sto\u00dfwellen die verkalkte Plaque frakturiert. Ziel ist, kalkbedingtes Recoil und Dissektionen zu reduzieren. Dieses Therapiekonzept wird aktuell neben der femoropoplitealen Strombahn in anderen Gef\u00e4\u00dfprovinzen wie Unterschenkel- und Beckenarterien in klinischen Studien erprobt.<\/jats:p><jats:p>Atherektomie-Systeme sind bereits seit mehr als einer Dekade zur Therapie der pAVK etabliert, insbesondere die direktionale Atherektomie erlaubt es, exzentrische verkalkte Plaques gezielt zu entfernen. Klinische Studien untersuchen den m\u00f6glicherweise additiven Effekt der Kombination einer mechanischen und biologischen Restenoseprophylaxe mittels DCB.<\/jats:p>","DOI":"10.1055\/a-1948-7298","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T22:46:05Z","timestamp":1685573165000},"page":"725-730","source":"Crossref","is-referenced-by-count":2,"title":["Endovaskul\u00e4re Therapie der pAVK \u2013 Therapieoptionen bei starker Verkalkung"],"prefix":"10.1055","volume":"148","author":[{"given":"Thomas","family":"Zeller","sequence":"additional","affiliation":[{"name":"Abteilung Angiologie, Universit\u00e4ts-Herzzentrum Freiburg \u2013 Bad Krozingen, Bad Krozingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Noory","sequence":"additional","affiliation":[{"name":"Abteilung Angiologie, Universit\u00e4ts-Herzzentrum Freiburg \u2013 Bad Krozingen, Bad Krozingen, 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