Raed Hamed - Academia.edu (original) (raw)

Papers by Raed Hamed

Research paper thumbnail of Hypoglossal nerve palsy due to internal carotid artery dissection with pseudoaneurysm formation: An unusual presentation

Acta radiologica open, Jun 1, 2022

Research paper thumbnail of The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator’s experience

Gland surgery, Oct 1, 2018

Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative... more Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from "knife-to-skin" to insertion of the last stitch. Results: One hundred and twenty patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (P=0.73). However, patients in the CT-VC group had significantly shorter operations vs. WI (472 vs. 586 min, P<0.00001) and vs. VC alone (472 vs. 572 min, P=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs. VC: 100 vs. 89 min, P=0.0106; VC vs. CT-VC: 89 vs. 80 min, P=0.0307; WI vs. CT-VC: 100 vs. 80 min, P<0.00001). Conclusions: Combination of CTA and VC significantly reduced operative and ischaemic times for FFBR; this was predominantly due to use of CTA. CTA mitigates the surgical learning curve as demonstrated by shorter operating times via providing a vascular anatomy roadmap, thus facilitating flap harvest.

Research paper thumbnail of Hypoglossal nerve palsy due to internal carotid artery dissection

Research paper thumbnail of The effect of CTA and venous couplers on surgery duration in microvascular breast reconstruction

Background: The use of CT angiography (CTA) or venous couplers (VC) has led to shorter operative ... more Background: The use of CT angiography (CTA) or venous couplers (VC) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with venous couplers only (VC), and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from “knife-to-skin” to insertion of the last stitch. Results: 120 patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (p=0.73). However, patients in the CT-VC group had significantly shorter operations versus WI (472vs586 mins, p<0.00001) and versus VC alone (472vs572 mins, p=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs VC: 100vs89 mins, ...

Research paper thumbnail of Implications of abnormal abdominal wall computed tomographic angiography findings on postmastectomy free flap breast reconstruction

Archives of Plastic Surgery

Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is us... more Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan.Methods We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected.Results Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were “miscellaneous.” In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, a...

Research paper thumbnail of The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator’s experience

Gland Surgery

Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative... more Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from "knife-to-skin" to insertion of the last stitch. Results: One hundred and twenty patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (P=0.73). However, patients in the CT-VC group had significantly shorter operations vs. WI (472 vs. 586 min, P<0.00001) and vs. VC alone (472 vs. 572 min, P=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs. VC: 100 vs. 89 min, P=0.0106; VC vs. CT-VC: 89 vs. 80 min, P=0.0307; WI vs. CT-VC: 100 vs. 80 min, P<0.00001). Conclusions: Combination of CTA and VC significantly reduced operative and ischaemic times for FFBR; this was predominantly due to use of CTA. CTA mitigates the surgical learning curve as demonstrated by shorter operating times via providing a vascular anatomy roadmap, thus facilitating flap harvest.

Research paper thumbnail of The Role of CT Angiography in Assessing Deep Inferior Epigastric Perforator Flap Patency in Patients With Pre-existing Abdominal Scars

Journal of Surgical Research

Research paper thumbnail of Hypoglossal nerve palsy due to internal carotid artery dissection with pseudoaneurysm formation: An unusual presentation

Acta radiologica open, Jun 1, 2022

Research paper thumbnail of The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator’s experience

Gland surgery, Oct 1, 2018

Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative... more Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from "knife-to-skin" to insertion of the last stitch. Results: One hundred and twenty patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (P=0.73). However, patients in the CT-VC group had significantly shorter operations vs. WI (472 vs. 586 min, P<0.00001) and vs. VC alone (472 vs. 572 min, P=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs. VC: 100 vs. 89 min, P=0.0106; VC vs. CT-VC: 89 vs. 80 min, P=0.0307; WI vs. CT-VC: 100 vs. 80 min, P<0.00001). Conclusions: Combination of CTA and VC significantly reduced operative and ischaemic times for FFBR; this was predominantly due to use of CTA. CTA mitigates the surgical learning curve as demonstrated by shorter operating times via providing a vascular anatomy roadmap, thus facilitating flap harvest.

Research paper thumbnail of Hypoglossal nerve palsy due to internal carotid artery dissection

Research paper thumbnail of The effect of CTA and venous couplers on surgery duration in microvascular breast reconstruction

Background: The use of CT angiography (CTA) or venous couplers (VC) has led to shorter operative ... more Background: The use of CT angiography (CTA) or venous couplers (VC) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with venous couplers only (VC), and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from “knife-to-skin” to insertion of the last stitch. Results: 120 patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (p=0.73). However, patients in the CT-VC group had significantly shorter operations versus WI (472vs586 mins, p<0.00001) and versus VC alone (472vs572 mins, p=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs VC: 100vs89 mins, ...

Research paper thumbnail of Implications of abnormal abdominal wall computed tomographic angiography findings on postmastectomy free flap breast reconstruction

Archives of Plastic Surgery

Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is us... more Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan.Methods We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected.Results Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were “miscellaneous.” In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, a...

Research paper thumbnail of The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator’s experience

Gland Surgery

Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative... more Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from "knife-to-skin" to insertion of the last stitch. Results: One hundred and twenty patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (P=0.73). However, patients in the CT-VC group had significantly shorter operations vs. WI (472 vs. 586 min, P<0.00001) and vs. VC alone (472 vs. 572 min, P=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs. VC: 100 vs. 89 min, P=0.0106; VC vs. CT-VC: 89 vs. 80 min, P=0.0307; WI vs. CT-VC: 100 vs. 80 min, P<0.00001). Conclusions: Combination of CTA and VC significantly reduced operative and ischaemic times for FFBR; this was predominantly due to use of CTA. CTA mitigates the surgical learning curve as demonstrated by shorter operating times via providing a vascular anatomy roadmap, thus facilitating flap harvest.

Research paper thumbnail of The Role of CT Angiography in Assessing Deep Inferior Epigastric Perforator Flap Patency in Patients With Pre-existing Abdominal Scars

Journal of Surgical Research