Publications by authors named "Jose Fernandes E Fernandes"

Article Synopsis
  • The Delphi consensus aimed to clarify management practices for abdominal aortic aneurysms (AAAs) due to conflicting data in previous literature.
  • A group of 44 experts anonymously discussed six key topics over three rounds, achieving a 100% response rate.
  • Key findings included the agreement on minimum case volume for AAA repairs, the effectiveness of screening programs, lifelong surveillance after repair, and the consideration of screening for women smokers at 65, but no consensus on certain repair thresholds or thrombosis prevention was reached.
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Cardiovascular disease (CVD) diagnosis and treatment are challenging since symptoms appear late in the disease's progression. Despite clinical risk scores, cardiac event prediction is inadequate, and many at-risk patients are not adequately categorised by conventional risk factors alone. Integrating genomic-based biomarkers (GBBM), specifically those found in plasma and/or serum samples, along with novel non-invasive radiomic-based biomarkers (RBBM) such as plaque area and plaque burden can improve the overall specificity of CVD risk.

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Background: The field of precision medicine endeavors to transform the healthcare industry by advancing individualised strategies for diagnosis, treatment modalities, and predictive assessments. This is achieved by utilizing extensive multidimensional biological datasets encompassing diverse components, such as an individual's genetic makeup, functional attributes, and environmental influences. Artificial intelligence (AI) systems, namely machine learning (ML) and deep learning (DL), have exhibited remarkable efficacy in predicting the potential occurrence of specific cancers and cardiovascular diseases (CVD).

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Article Synopsis
  • The study investigates how well specific features of carotid plaque can predict the risk of coronary artery disease (CAD) and cardiovascular (CV) events using deep learning (DL) compared to traditional machine learning (ML).
  • It involved 459 participants who underwent various imaging techniques, and metrics like maximum plaque height and intraplaque neovascularization were analyzed over a period of 30 days.
  • The results revealed that DL models significantly outperformed ML models in predicting CV events, with intraplaque neovascularization being a key indicator for increased risk.
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Introduction: Two of the main reasons recent guidelines do not recommend routine population-wide screening programs for asymptomatic carotid artery stenosis (AsxCS) is that screening could lead to an increase of carotid revascularization procedures and that such mass screening programs may not be cost-effective. Nevertheless, selective screening for AsxCS could have several benefits. This article presents the rationale for such a program.

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Cardiovascular disease (CVD) related mortality and morbidity heavily strain society. The relationship between external risk factors and our genetics have not been well established. It is widely acknowledged that environmental influence and individual behaviours play a significant role in CVD vulnerability, leading to the development of polygenic risk scores (PRS).

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Objective: Despite the publication of various national/international guidelines, several questions concerning the management of patients with asymptomatic (AsxCS) and symptomatic (SxCS) carotid stenosis remain unanswered. The aim of this international, multi-specialty, expert-based Delphi Consensus document was to address these issues to help clinicians make decisions when guidelines are unclear.

Methods: Fourteen controversial topics were identified.

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Article Synopsis
  • A recent update was made about how to manage patients with asymptomatic carotid stenosis (AsxCS), which means they have a narrow artery but don’t show symptoms.
  • Researchers looked at studies until August 2023 to learn about new treatments and techniques for these patients.
  • It's important to provide medical treatment to all patients, but some with specific risks may need surgery, and decisions should be based on individual needs and situations.
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Background: Cardiovascular disease (CVD) is challenging to diagnose and treat since symptoms appear late during the progression of atherosclerosis. alone are not always sufficient to properly categorize at-risk patients, and are inadequate in predicting cardiac events. Integrating (GBBM) found in plasma/serum samples with novel non-invasive (RBBM) such as plaque area, plaque burden, and maximum plaque height can improve composite CVD risk prediction in the pharmaceutical paradigm.

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Introduction And Objectives: Management of aortic dissection is rapidly evolving. The present study aims to assess paradigm shifts in type B aortic dissection (TBAD) treatment modalities and their outcomes according to clinical presentation and type of treatment. We also aim to assess the impact of endovascular technology in TBAD management in order to define organizational strategies to provide an integrated cardiovascular approach.

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: The price of medical treatment continues to rise due to (i) an increasing population; (ii) an aging human growth; (iii) disease prevalence; (iv) a rise in the frequency of patients that utilize health care services; and (v) increase in the price. Artificial Intelligence (AI) is already well-known for its superiority in various healthcare applications, including the segmentation of lesions in images, speech recognition, smartphone personal assistants, navigation, ride-sharing apps, and many more. Our study is based on two hypotheses: (i) AI offers more economic solutions compared to conventional methods; (ii) AI treatment offers stronger economics compared to AI diagnosis.

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Background: The optimal antithrombotic (antiplatelet or anticoagulant) treatment of patients undergoing extracranial carotid artery interventions is a subject of debate. The aim of this multidisciplinary document was to critically review the recommendations of current guidelines, taking into consideration the results of recently published studies.

Methods: The various antithrombotic strategies reported were evaluated for asymptomatic and symptomatic patients undergoing extracranial carotid artery interventions (endarterectomy, transfemoral carotid artery stenting [CAS] or transcarotid artery revascularization [TCAR]).

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Article Synopsis
  • Current guidelines advise against screening for asymptomatic carotid artery stenosis (AsxCS) due to the risk of unnecessary interventions, unlike the strong recommendation for abdominal aortic aneurysm screening.
  • A literature analysis reveals that patients with AsxCS are at a high risk for future cardiovascular issues, yet universal screening is not advisable.
  • Selective screening for high-risk individuals could be beneficial, focusing on risk factor management and medical therapy to prevent future cardiovascular events rather than identifying candidates for surgery.
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Article Synopsis
  • - The position paper from the IUA Youth Committee and experts reviews treatment methods for patients with chronic limb-threatening ischemia (CLTI) who lack standard revascularization options.
  • - It emphasizes the importance of effectively managing "no-option" CLTI patients, focusing on wound care and rehabilitation.
  • - The ultimate goal is to improve the quality of life for these patients through tailored therapeutic approaches.
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  • The study investigates the challenges of starting an endovascular aortic program using fenestrated and branched grafts (FB-EVAR) and evaluates the role of a Proctor in training the surgical team.
  • Researchers conducted a retrospective analysis of 105 elective patients who underwent FB-EVAR between 2013 and 2021, comparing outcomes with and without the Proctor's presence during procedures.
  • Findings showed no significant differences in 30-day mortality or technical success between the Proctor and non-Proctor groups, but the non-Proctor group had longer surgical times and more blood loss, suggesting the Proctor may contribute to certain efficiency improvements.
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Article Synopsis
  • International guidelines recommend using statins, alone or with other medications, to lower LDL cholesterol in patients with asymptomatic or symptomatic carotid stenosis, as it significantly reduces risks of stroke and cardiovascular events.
  • The overview evaluates the effectiveness of various lipid-lowering agents, emphasizing that statins and PCSK9 inhibitors offer substantial benefits like stabilizing carotid plaques and lowering stroke rates, while non-statin options like ezetimibe and fibrates also help but to a lesser extent.
  • Despite potential side effects, the advantages of lowering LDL cholesterol for these patients outweigh the risks, leading to a recommendation for high-dose statin therapy for all individuals, regardless of their baseline LDL levels.
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Despite the publication of several national/international guidelines, the optimal management of patients with asymptomatic carotid stenosis (AsxCS) remains controversial. This article compares 3 recently released guidelines (the 2020 German-Austrian, the 2021 European Stroke Organization [ESO], and the 2021 Society for Vascular Surgery [SVS] guidelines) vs the 2017 European Society for Vascular Surgery (ESVS) guidelines regarding the optimal management of AsxCS patients.The 2017 ESVS guidelines defined specific imaging/clinical parameters that may identify patient subgroups at high future stroke risk and recommended that carotid endarterectomy (CEA) should or carotid artery stenting (CAS) may be considered for these individuals.

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The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement was to reconcile the conflicting views on the topic. A literature review was performed with a focus on data from recent studies.

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Objectives: The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic.

Materials And Methods: A literature review was performed with a focus on data from recent studies.

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The Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS) was founded in 2018, with the aim to promote cooperation among vascular professionals within Mediterranean countries. Due to its prominent social and economic impact on national health systems, diabetic peripheral artery was selected as the very first topic to be investigated by the federation. In this second paper, different experiences from delegates of participating countries were shared to define common strategies to harmonize, standardize, and optimize education and training in the Vascular Surgery specialty.

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The optimal management of patients with asymptomatic carotid stenosis (ACS) is the subject of extensive debate. According to the 2017 European Society for Vascular Surgery Guidelines, carotid endarterectomy should (Class IIa; Level of Evidence: B) or carotid artery stenting may be considered (Class IIb; Level of Evidence: B) in the presence of one or more clinical/imaging characteristics that may be associated with an increased risk of late ipsilateral stroke (e.g.

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