PHOTO SIGNATURE: Igor Končar, PhD, MD (photo: personal archive)
Our well-known vascular surgeon, Igor Končar, PhD, MD, talks to Heliant about the advantages of using artificial intelligence in healthcare, which will help doctors treat patients by a personalized medical approach. He is one of the initiators of the SerbVasc vascular registry, which can help improve the treatment of vicious diseases, such as abdominal aortic aneurysms.
He performs open and endovascular surgical procedures at the University Clinical Centre of Serbia. He treats diseases of the aorta, carotid arteries and veins of the lower extremities, and his narrow area of interest are minimally invasive procedures on the thoracic and abdominal aorta.
Končar, who has studied in Spain and Italy on several occasions, is very interested in interdisciplinary research and projects that, in addition to medicine, include biomechanics and genetics.
We talked with him about the vascular surgery registry and the role that digital solutions have in this branch of medicine.
Heliant: As one of the initiators of the vascular registry SerbVasc, can you tell us more about this project?
Dr Igor Končar: SerbVasc je nastavak velikog evropskog registra koji se zove Vascunet. Njega su pre 20 godina formirali švedski vaskularni hirurzi, posle čega se proširio na druge zemlje. Danas obuhvata sve zemlje Evropske unije, Australiju, Novi Zeland, i Srbiju, kao jedinu evropsku zemlju van EU. Vascunet sarađuje i sa američkom asocijacijom registara.
SerbVasc practically represents our Vascunet registry office. SerbVasc is not a national registry, but it includes all hospitals that are interested in participating in it. SerbVasc was initiated in 2020 by professor Davidović, MD, PhD together with me.
In addition to the Clinical Centre of Serbia and the Institute for Vascular Diseases “Dedinje”, the Vascular Clinic of the Military Medical Academy, Vascular Surgery Department of the Clinical Centre Kragujevac, Niš, Vascular Surgery Department of Užice Hospital, Subotica Hospital, CHC Bežanijska Kosa, CHC Zemun, Gornji Milanovac Hospital, Požarevac Hospital are participating in the project.
Heliant: What are the plans when it comes to working on the registry?
Končar: They mainly refer to the improvement of data entry in the registry and the coverage of other hospitals, such as the Clinical Centre of Vojvodina, which will join the registry this year.
Heliant: What are the benefits for doctors and patients from the SerbVasc registry?
Končar: As with all other registries, SerbVasc will only provide data in the coming years, not only for doctors who enter them in the registry, but also for others who are interested in improving the treatment of patients with vascular diseases.
We already have interesting data on patients who undergo amputation procedures in Serbia, as well as on mortality after such surgeries.
SerbVasc will also detect a significant number of other risk groups, which may not be sufficiently recognized in our population and whose treatment could be improved, help reduce mortality and complications and prevent some diseases.
The doctors will certainly benefit from scientific publications that will result from this registry and which will contribute not only to the affirmation of that registry, but also to our vascular surgery accomplishments.
Heliant: Is there a screening program for abdominal aortic aneurysms in our country and can digitalization in healthcare improve the coverage of the program?
Končar: Abdominal aortic aneurysm is an important and very common disease in patients with vascular diseases. It is an insidious disease that does not give any symptoms, and then at one point there occurs a rupture that is fatal in almost 80 percent of cases.
Abdominal aortic aneurysm screening is performed in a small number of countries and they have indeed reduced mortality from this disease and increased the number of detected cases. They have reduced the number of ruptured aneurysms, which are the biggest complication of this disease.
Digitization in healthcare can certainly improve the coverage of the program and it really helps a lot. It would facilitate the screening program, and with the help of the collected data, the screening program could certainly be improved over time.pređuje.
I think that programs that are related to national information systems are particularly important – those that can connect national information systems, that can connect hospitals, that have links to the deaths registry and some other data that may be useful for detecting or tracking these patients.
Heliant: How can technology help identify patients at risk for abdominal aortic aneurysm rupture?
Končar: Now, artificial intelligence is being used more and more to prevent that. At the moment, the most helpful thing is to identify known risk factors, and/or to identify patients at risk.
Another advantage of the technology is the performance of ultrasound examinations, which helps to make the examination fast, automatic, efficient, accurate, in order to increase the number of patients that can undergo the screening process.
Heliant:We are searching for a formula of individuality for each patient, so that we can predict when such a complication could occur and operate on the patient before that. It is utopian at this point to expect this to be so precise. For now, researches are conducted at the level of classification of patients into lower, medium and high risk patient groups.
Končar: We are currently part of a European project that uses artificial intelligence for diseases of blood vessels in the neck, carotid arteries, which is trying to create a model that classifies patients at different levels of risk. For that, large databases are used, which contain data on a large number of patients, where the outcomes of the disease and complications have been recorded.
In that way, using artificial intelligence, a model is created that could help the doctor treat patients by personalized medical approach. Thus, according to the level of risk, the level of therapy, its intensity, intensity of monitoring could be determined …
Artificial intelligence can also help predict the development of the disease. When a disease is diagnosed, there is now software that is being developed, not yet in clinical practice, but that can predict how fast and how a disease will develop.
As far as vascular surgery is concerned, research is currently mostly focused on predicting and detecting those patients who are at increased risk of developing complications.
First of all, I am thinking of carotid disease of the blood vessels of the neck and aneurysm of the abdominal aorta. Both diseases are similar in their dynamics, they are asymptomatic for a long time, and then suddenly they become symptomatic to such an extent that they make someone disabled, that is, to take someone’s life immediately.
Early detection and timely surgery are important to prevent this. We are working on the selection of patients in whom the surgery would be most beneficial, since the surgery also poses a risk, so with the help of such a selection, patients would not be exposed to risk prematurely.
We are searching for a formula of individuality for each patient, so that we can predict when such a complication could occur and operate on the patient before that. It is utopian at this point to expect this to be so precise. For now, researches are conducted at the level of classification of patients into lower, medium and high risk patient groups.