{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T22:44:03Z","timestamp":1781995443257,"version":"3.54.5"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die kathetergest\u00fctzte Atherektomie wird hinsichtlich ihrer Indikation seit Jahren kontrovers diskutiert. Neuere Studiendaten zeigen, dass multifunktionelle Atherektomiesysteme mit\n            geringem Materialaufwand auch f\u00fcr komplexe L\u00e4sionen eine Alternative zum Bypass darstellen k\u00f6nnen, obwohl der direkte Vergleich noch fehlt.<\/jats:p><jats:p>Die Ergebnisse der ByCross-Zulassungsstudie wurden mit den technischen und klinischen Daten anderer Atherektomiesysteme in Bezug auf die Indikationsbreite, die herstellerseitigen\n            Limitierungen, die technische Erfolgs- und Komplikationsrate und die jeweiligen Instruktionen f\u00fcr den Einsatz verglichen. Dabei war in allen rezenten Studien eine Residualstenose von \u2264\u00a050%\n            nach Atherektomie und \u2264\u00a030% in der abschlie\u00dfenden Gef\u00e4\u00dfdarstellung als ein prim\u00e4rer Endpunkt und als Beweis des technischen Erfolges angegeben.<\/jats:p><jats:p>F\u00fcr die ByCross-Studie wurden deutlich komplexere, langstreckig schwer verkalkte Gef\u00e4\u00dfl\u00e4sionen eingeschlossen als f\u00fcr andere Zulassungsstudien. Dies betrifft nicht nur die L\u00e4sionsl\u00e4nge\n            (124,7\u00a0mm vs. 34\u00a0mm in der EASE-Studie oder 67,2\u00a0mm in der VISION-Studie) und den Stenosegrad (99,4% vs. 88,5% in der EASE- und 78,7% in der VISION-Studie). Auch der Kalzifizierungsgrad,\n            der anhand des Peripheral Artery Calcification Severity Score (PACSS) definiert wurde, war h\u00f6her als in anderen Studien. Dennoch lag die technische Erfolgsrate, wie vorgegeben, \u00fcber 95%.\n            W\u00e4hrend das ByCross ohne vorherige Drahtpassage als Crossingsystem eingesetzt werden kann (26,82% der F\u00e4lle), ist die prim\u00e4re intraluminale Passage des Drahtes f\u00fcr alle weiteren Systeme\n            vorgeschrieben. Das ByCross hat einen gr\u00f6\u00dfenvariablen Kopf, der einen Lumengewinn von 4,7\u00a0mm erlaubt, ohne dass Systeme ausgetauscht werden oder aufgrund von Laufzeitlimitierungen\n            pausieren m\u00fcssen. Das ByCross war das einzige System im Vergleich mit 0% Embolierate, was auf das Wirkprinzip und die hohe Aspirationskraft des Systems zur\u00fcckf\u00fchrbar ist. Gef\u00e4\u00dfverletzungen\n            traten ebenso nicht auf. Die 6-Monats-Ergebnisse zeigen den Langzeiterfolg des Verfahrens mit 0% Revaskularisationsrate.<\/jats:p><jats:p>Atherektomiesysteme der neuesten Generation stellen eine sichere und effektive Erweiterung des endovaskul\u00e4ren Portfolios dar. Das ByCross-System hebt sich durch die breitere Zulassung und\n            die Multifunktionalit\u00e4t als investmentfreie Atherektomie-, Thrombektomie- und Crossingdevice f\u00fcr iliakale wie femorodistale Gef\u00e4\u00dfl\u00e4sionen deutlich von den anderen Systemen ab und kann in\n            komplexen Verschlussmorphologien als Alternative zum Bypass gesehen werden.<\/jats:p>","DOI":"10.1055\/a-2156-5891","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T23:01:36Z","timestamp":1694559696000},"page":"429-437","source":"Crossref","is-referenced-by-count":4,"title":["Atherektomie mit einem neuen System, das noch mehr kann"],"prefix":"10.1055","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6827-8584","authenticated-orcid":false,"given":"J\u00f6rg","family":"Te\u00dfarek","sequence":"additional","affiliation":[{"name":"Gef\u00e4\u00dfchirurgie, Bonifatius-Hospital, Lingen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Elger","sequence":"additional","affiliation":[{"name":"Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum G\u00f6ttingen, Gottingen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Kolvenbach","sequence":"additional","affiliation":[{"name":"Gef\u00e4\u00dfchirurgie, Sana Kliniken D\u00fcsseldorf GmbH, D\u00fcsseldorf, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Liebetrau","sequence":"additional","affiliation":[{"name":"Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Augsburg, Augsburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1177\/1526602818763352","article-title":"Endovascular Treatment of Severely Calcified 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