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Dive into the research topics where Y. Onuma is active.

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Featured researches published by Y. Onuma.


Circulation | 2011

Bioresorbable Scaffold The Advent of a New Era in Percutaneous Coronary and Peripheral Revascularization

Y. Onuma; Patrick W. Serruys

The invention of balloon angioplasty as a percutaneous treatment for obstructive coronary disease by Andreas Gruntzig in 1977 was a huge leap forward in cardiovascular medicine and undoubtedly will always be remembered as a revolution in the field of revascularization. However, this technique was plagued by multiple problems, including the risk of acute vessel closure secondary to occlusive coronary dissection, sometimes necessitating emergency coronary artery bypass surgery.1,–,3 Although late luminal enlargement and vascular remodeling could take place, more often restenosis4,–,8 would occur instead. The restenosis would essentially be caused by constrictive remodeling9,–,13 and, to a lesser extent, by elastic recoil14 or the neointimal hyperplastic healing response.15,–,17 The advent of bare metal stenting (BMS) and the landmark Belgian-Netherlands Stent Study (BENESTENT) and Stent Restenosis Study (STRESS) trials have established BMS as the second revolution in interventional cardiology.18,19 This technology provided a solution to acute vessel occlusion by sealing the dissection flaps and preventing recoil. The rate of subacute occlusion was reduced to 1.5%, making emergency bypass surgery a rare occurrence. Restenosis rates were further reduced from 32% to 22% at 7 months, but this rate was still high, and neointimal hyperplasia inside the stent was even more prominent than with angioplasty, necessitating repeat treatment in numerous patients.18 Because the vessel was now caged with metal, late luminal enlargement and advantageous vascular remodeling could no longer occur. Another problem, namely late stent thrombosis (ST), was also first described.20 To solve the problem of in-stent restenosis, after the historic failure of brachytherapy to resolve this problem,21,22 drug-eluting stents (DES) were introduced. The first 45 patients implanted with the sirolimus-eluting Bx velocity stent (Cordis, Johnson …


Heart | 2009

Optical Coherence Tomography Assessment Of The Acute Effects Of Stent Implantation On The Vessel Wall. A Systematic Quantitative Approach

Nieves Gonzalo; P. W. Serruys; Takayuki Okamura; Zhu Jun Shen; Y. Onuma; Hector M. Garcia-Garcia; Giovanna Sarno; Carl Schultz; R.J.M. van Geuns; J. Ligthart; E. Regar

Objective: To observe and characterise vessel injury after stenting using optical coherence tomography (OCT), to propose a systematic OCT classification for periprocedural vessel trauma, to evaluate its frequency in stable versus unstable patients and to assess its clinical impact during the hospitalisation period. Setting: Stenting causes vessel injury. Design and interventions: All consecutive patients in whom OCT was performed after stent implantation were included in the study. Qualitative and quantitative assessment of tissue prolapse, intra-stent dissection and edge dissection were performed. Results: Seventy-three patients (80 vessels) were analysed. Tissue prolapse within the stented segment was visible in 78/80 vessels (97.5%). Median number of tissue prolapse sites was 8 (IQR 4–19), mean (SD) area 1.04 (0.9) mm2. Intra-stent dissection flaps were visible in 69/80 vessels (86.3%) (median number 3 (IQR 1.25–6), maximum flap length 450 (220) μm). Fifty-five out of 80 vessels (68.8%) showed dissection cavities (median number 2 (IQR 0–4.75), maximum depth 340 (170) μm). Edge dissection was visible in 20 vessels (mean (SD) length flap 744 (439) μm). The frequency of tissue prolapse or intra-stent dissection was similar in stable and unstable patients (95.6% vs 100%, p = 0.5 for tissue prolapse; 91.1% vs 82.9%, p = 0.3 for intra-stent dissection). There were no events during the hospitalisation period. Conclusions: OCT allows a detailed visualisation of vessel injury after stent implantation and enables a systematic classification and quantification in vivo. In this study, frequency of tissue prolapse or intra-stent dissections after stenting was high, irrespective of the clinical presentation of the patients, and was not associated with clinical events during hospitalisation.


Eurointervention | 2010

Three-year results of clinical follow-up after a bioresorbable everolimus-eluting scaffold in patients with de novo coronary artery disease: The ABSORB trial

Y. Onuma; Patrick W. Serruys; John Ormiston; Evelyn Regar; Mark Webster; Leif Thuesen; Dariusz Dudek; Susan Veldhof; Richard Rapoza

AIMS Multimodality imaging of the first-in-man trial using a fully resorbable everolimus-eluting scaffold (BVS, Abbott Vascular, Santa Clara, CA, USA) demonstrated at two years the bioresorption of the device while preventing restenosis. Nevertheless, the long-term safety and efficacy of this novel therapy remain to be documented. METHODS AND RESULTS The ABSORB trial completed in July 2006 at four clinical sites in Europe and New Zealand the enrolment of 30 patients with a single de novo native coronary artery lesion. The major clinical endpoint was ischaemia-driven major adverse cardiac events (ID-MACE) defined as a composite of cardiac death, myocardial infarction, or ischaemia-driven target lesion revascularisation. Clinical follow-up was available in 29 patients since one patient withdrew consent. At 46 days, one patient experienced a single episode of chest pain and underwent a diagnostic optical coherence tomography and subsequently a target lesion revascularisation with slight troponin rise after the procedure. At 3-year the hierarchical ID-MACE of 3.4% remained unchanged. Clopidogrel therapy was discontinued in all but one patient. There has been no stent thrombosis reported. Two non-cardiac deaths were reported; one from duodenal perforation, the other from Hodgkin disease. Two patients underwent non-ischaemia driven target vessel revascularisation. CONCLUSIONS Three-year clinical results have demonstrated a sustained low MACE rate (3.4%) without any late complication such as stent thrombosis.


PLOS ONE | 2018

Mid-term outcomes of the absorb bvs versus second-generation des: A systematic review and meta-analysis

Cordula Felix; V.J. van den Berg; S.E. Hoeks; J.M. Fam; Mattie J. Lenzen; E. Boersma; P.C. Smits; P. W. Serruys; Y. Onuma; R.J.M. van Geuns

Background Bioresorbable Vascular Scaffolds (BVS) were introduced to overcome some of the limitations of drug-eluting stent (DES) for PCI. Data regarding the clinical outcomes of the BVS versus DES beyond 2 years are emerging. Objective To study mid-term outcomes. Methods We searched online databases (PubMed/Medline, Embase, CENTRAL), several websites, meeting presentations and scientific session abstracts until August 8th, 2017 for studies comparing Absorb BVS with second-generation DES. The primary outcome was target lesion failure (TLF). Secondary outcomes were all-cause mortality, myocardial infarction, target lesion revascularization (TLR) and definite/probable device thrombosis. Odds ratios (ORs) with 95% confidence intervals (CIs) were derived using a random effects model. Results Ten studies, seven randomized controlled trials and three propensity-matched observational studies, with a total of 7320 patients (BVS n = 4007; DES n = 3313) and a median follow-up duration of 30.5 months, were included. Risk of TLF was increased for BVS-treated patients (OR 1.34 [95% CI: 1.12–1.60], p = 0.001, I2 = 0%). This was also the case for all myocardial infarction (1.58 [95% CI: 1.27–1.96], p<0.001, I2 = 0%), TLR (1.48 [95% CI: 1.19–1.85], p<0.001, I2 = 0%) and definite/probable device thrombosis (of 2.82 (95% CI: 1.86–3.89], p<0.001 and I2 = 40.3%). This did not result in a difference in all-cause mortality (0.78 [95% CI: 0.58–1.04], p = 0.09, I2 = 0%). OR for very late (>1 year) device thrombosis was 6.10 [95% CI: 1.40–26.65], p = 0.02). Conclusion At mid-term follow-up, BVS was associated with an increased risk of TLF, MI, TLR and definite/probable device thrombosis, but this did not result in an increased risk of all-cause mortality.


Circulation | 2011

Bioresorbable scaffold technologies.

Y. Onuma; John A. Ormiston; Patrick W. Serruys


Eurointervention | 2014

Fast virtual functional assessment of intermediate coronary lesions using routine angiographic data and blood flow simulation in humans: comparison with pressure wire - fractional flow reserve.

Michail I. Papafaklis; Takashi Muramatsu; Yuki Ishibashi; Lampros Lakkas; Shimpei Nakatani; Christos V. Bourantas; Jurgen Ligthart; Y. Onuma; Mauro Echavarria-Pinto; Georgia Tsirka; Anna Kotsia; Dimitrios Nikas; Mogabgab O; van Geuns Rj; Katerina K. Naka; Dimitrios I. Fotiadis; Brilakis Es; Hector M. Garcia-Garcia; Javier Escaned; Felix Zijlstra; Lampros K. Michalis; Patrick W. Serruys


Eurointervention | 2017

Potentially increased incidence of scaffold thrombosis in patients treated with Absorb BVS who terminated DAPT before 18 months

Cordula Felix; Georgios J. Vlachojannis; J.M. Fam; P.C. Smits; Wouter Lansink; Roberto Diletti; F. Zijlstra; E. Regar; E. Boersma; Y. Onuma; R.J.M. van Geuns


European Heart Journal | 2018

P2639Clinical outcomes with the state-of-the-art PCI for the treatment of bifurcation lesions: a sub-analysis of the SYNTAX II study

Rodrigo Modolo; Carlos Collet; Yosuke Miyazaki; Ply Chichareon; Taku Asano; Yuki Katagiri; Erhan Tenekecioglu; Simon Walsh; Maciej Lesiak; Raúl Moreno; Javier Escaned; Adrian P. Banning; Y. Onuma; Patrick W. Serruys


European Heart Journal | 2018

P573Angiographic late lumen loss revisited: impact on target lesion revascularization and device thrombosis

Taku Asano; Y. Onuma; Carlos Collet; Manel Sabaté; Marie-Claude Morice; Bernard Chevalier; S Windecker; Patrick W. Serruys


European Heart Journal | 2018

P3627The assessment of microvascular resistance and conductance three years after the implantation of Absorb bioresorbable vascular scaffold and Xience metallic stent: ABSORB II pressure-velocity substudy

Taku Asano; Y. Onuma; Javier Escaned; R. van der Schaaf; R.J.M. van Geuns; Jan J. Piek; Patrick W. Serruys

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R.J.M. van Geuns

Erasmus University Rotterdam

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Taku Asano

University of Amsterdam

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Cordula Felix

Erasmus University Rotterdam

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E. Regar

Erasmus University Medical Center

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J.M. Fam

Erasmus University Rotterdam

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P. W. Serruys

Erasmus University Rotterdam

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Roberto Diletti

Erasmus University Rotterdam

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