{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T22:44:04Z","timestamp":1781995444428,"version":"3.54.5"},"reference-count":50,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die periphere arterielle Verschlusskrankheit (pAVK) ist in dem \u00fcberwiegenden Anteil\n\t\t\tder F\u00e4lle durch stenosierende atherosklerotische L\u00e4sionen der peripheren Arterien der\n\t\t\tunteren Extremit\u00e4t bedingt. Neben asymptomatischen Verl\u00e4ufen ist die intermittierende\n\t\t\tClaudicatio-Symptomatik die h\u00e4ufigste Manifestation, im fortgeschritteneren Stadium der\n\t\t\tErkrankung tritt eine chronische extremit\u00e4tenbedrohende Isch\u00e4mie (CLTI) auf. Die\n\t\t\tkonservativ-medikament\u00f6se sekund\u00e4rpr\u00e4ventive Therapie repr\u00e4sentiert einen wesentlichen\n\t\t\tGrundpfeiler in allen Stadien der pAVK, w\u00e4hrend die endovaskul\u00e4re und die offene\n\t\t\tgef\u00e4\u00dfchirurgische Revaskularisation je nach Patienten- und L\u00e4sionsmerkmalen einen hohen\n\t\t\tStellenwert besitzen und komplement\u00e4r oder kombiniert zum Einsatz kommen k\u00f6nnen. Bei Patienten mit\n\t\t\tClaudicatio ist die Verbesserung der schmerzfreien Gehstrecke das prim\u00e4re Therapieziel,\n\t\t\tw\u00e4hrend bei Patienten mit CLTI das amputationsfreie \u00dcberleben im Vordergrund steht. In\n\t\t\tbeiden Patientengruppen besteht die Notwendigkeit der strengen Kontrolle der\n\t\t\tkardiovaskul\u00e4ren Risikofaktoren, inkl. der Blutdruck- und Diabeteseinstellung,\n\t\t\tNikotinkarenz und Reduktion der Cholesterinwerte mittels intensiver Statintherapie,\n\t\t\tgem\u00e4\u00df nationalen und internationalen Leitlinien. Die endovaskul\u00e4re Behandlung der pAVK\n\t\t\twird breitfl\u00e4chig und von verschiedenen Fachdisziplinen eingesetzt. Herk\u00f6mmliche\n\t\t\tendovaskul\u00e4re Therapieverfahren weisen jedoch bei komplexen und stark kalzifizierten\n\t\t\tL\u00e4sionen Limitationen auf, sodass z.\u00a0B. die klassische Ballonangioplastie bei solchen\n\t\t\tL\u00e4sionen mit \u201eRecoil\u201c (Zusammenziehen) und\/oder schweren Dissektionen (Gef\u00e4\u00dfeinrisse bis\n\t\t\thin zum Gef\u00e4\u00dfverschluss) assoziiert ist, die i.\u00a0d.\u00a0R. eine Stentimplantation\n\t\t\terforderlich machen. Verfahren zur L\u00e4sionspr\u00e4paration wie die Atherektomie und die\n\t\t\tintravaskul\u00e4re Lithotripsie (IVL) k\u00f6nnen die Compliance von verkalkten Arterien\n\t\t\tverbessern, indem entweder Mikrofrakturen an verkalkten Stellen verursacht werden oder\n\t\t\tkalzifiziertes Material entfernt wird. Auf diesem Weg kann anschlie\u00dfend eine\n\t\t\tBallonangioplastie mit weniger Barotrauma erfolgen und die Notwendigkeit der\n\t\t\tStentimplantation reduziert werden, w\u00e4hrend die nachfolgende Behandlung mit\n\t\t\tmedikamentenbeschichteten Ballons (DCB) mit einer potenziell verbesserten Penetration\n\t\t\tdes Medikamentes in die Gef\u00e4\u00dfwand einhergeht, sodass die Wirksamkeit der entsprechenden\n\t\t\tantirestenotischen Effekte erh\u00f6ht werden kann. Im Folgenden werden M\u00f6glichkeiten und\n\t\t\tGrenzen der verschiedenen L\u00e4sionspr\u00e4parationsverfahren und sowie die aktuelle\n\t\t\tStudienlage vorgestellt und diskutiert.<\/jats:p>","DOI":"10.1055\/a-2540-3349","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T21:18:46Z","timestamp":1741987126000},"page":"408-419","source":"Crossref","is-referenced-by-count":3,"title":["L\u00e4sionspr\u00e4paration bei peripheren Arterien \u2013 Fact or Fashion?"],"prefix":"10.1055","volume":"150","author":[{"given":"Grigorios","family":"Korosoglou","sequence":"additional","affiliation":[{"name":"Kardiologie und Gef\u00e4\u00dfmedizin, GRN-Klinik Weinheim, Weinheim, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lichtenberg","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Angiologie, Klinikum Hochsauerland, Arnsberg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian A.","family":"Behrendt","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gef\u00e4\u00dfchirurgie und Endovaskul\u00e4re Chirurgie, Asklepios Klinik Wandsbek, Hamburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Angiologie und Interventionelle Angiologie, Universit\u00e4tsklinikum Leipzig, Leipzig, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Langhoff","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Angiologie und Gef\u00e4\u00dfmedizin, Sankt Gertrauden-Krankenhaus Berlin, Berlin, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Rammos","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie und Angiologie, Universit\u00e4tsklinik Duisburg-Essen, Essen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Blessing","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Angiologie und Gef\u00e4\u00dfmedizin, Universit\u00e4tsklinik Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dittmar","family":"B\u00f6ckler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gef\u00e4\u00dfchirurgie und Endovaskul\u00e4re Chirurgie, Universit\u00e4tsklinik Heidelberg, Heidelberg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Zeller","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie und Angiologie, Universit\u00e4tsklinik Freiburg\/Bad Krozingen, Bad Krozingen, 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