Imperial College London

DrHutanAshrafian

Faculty of MedicineDepartment of Surgery & Cancer

Honorary Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 3312 7651h.ashrafian

 
 
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Location

 

1089Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

573 results found

Ashrafian H, 2010, Familial Stroke 2700 Years Ago, STROKE, Vol: 41, Pages: E187-E187, ISSN: 0039-2499

Journal article

Vecht JA, von Segesser LK, Ashrafian H, Rao C, Skapinakis P, Saso S, Darzi A, Athanasiou Tet al., 2010, Translation to success of surgical innovation, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol: 37, Pages: 613-625, ISSN: 1010-7940

Journal article

Ashrafian H, Darzi A, Athanasiou T, 2010, Autobionics: a new paradigm in regenerative medicine and surgery, REGENERATIVE MEDICINE, Vol: 5, Pages: 279-288, ISSN: 1746-0751

Journal article

Jones CM, Ashrafian H, Darzi A, Athanasiou Tet al., 2010, Guidelines for Diagnostic Tests and Diagnostic Accuracy in Surgical Research, JOURNAL OF INVESTIGATIVE SURGERY, Vol: 23, Pages: 57-65, ISSN: 0894-1939

Journal article

Ali E, Saso S, Ashrafian H, Athanasiou Tet al., 2010, Does a skeletonized or pedicled right gastro-epiploic artery improve patency when used as a conduit in coronary artery bypass graft surgery?, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 10, Pages: 293-298, ISSN: 1569-9293

Journal article

Suliman A, Dialynas M, Ashrafian H, Bicknell C, Mireskandari M, Hamady M, Athanasiou Tet al., 2010, Acute Complex Type A Dissection associated with peripheral malperfusion syndrome treated with a staged approach guided by lactate levels, Journal of Cardiothoracic Surgery, Vol: 5, ISSN: 1749-8090

Acute type A aortic dissection can be complicated by visceral malperfusion and is associated with a significant surgical morbidity and mortality. We describe a case of successful management of a complex acute type A dissection with mesenteric and lower limb ischemia treated with endovascular thoracic stenting and femoro-femoral crossover bypass grafting followed by aortic arch repair. To accomplish this, we applied a staged therapeutic approach using serial lactate measurements to assess the adequacy of peripheral perfusion and metabolic status prior to surgical repair of the proximal dissection.

Journal article

Saso S, Vecht JA, Rao C, Protopapas A, Ashrafian H, Leff D, Darzi A, Athanasiou Tet al., 2010, Statin therapy may influence the incidence of postoperative atrial fibrillation: what is the evidence?, Texas Heart Institute Journal, Vol: 36, Pages: 521-529, ISSN: 1526-6702

Atrial fibrillation is the most common postoperative arrhythmia in patients who undergo cardiac surgery. We sought to determine whether the administration of statins reduces the incidence of postoperative atrial fibrillation in cardiac surgery patients. We performed a meta-analysis on all studies published between 2004 and 2008 that reported comparisons between statin treatment or nontreatment in these patients. Our primary focus was the incidence of postoperative atrial fibrillation. Random-effects modeling and sensitivity analysis were used to evaluate the consistency of the calculated treatment effect. Ten qualifying studies generated a total of 4,459 patients. The incidence of postoperative atrial fibrillation was 22.6% (622/2,758) in the statin-treated group and 29.8% (507/1,701) in the untreated group. Using the random-effects model, we calculated an odds ratio (OR) of 0.60 (95% confidence interval [CI], 0.48-0.76). When we considered only the 4 randomized studies (919 patients) in order to reduce the effects of heterogeneity, this significant reduction in the incidence of postoperative atrial fibrillation in the statin group was maintained (OR, 0.55; 95% CI, 0.41-0.73) with no heterogeneity (chi2 of heterogeneity, 2.96; P = 0.4). In studies wherein only coronary artery bypass grafting was performed, statin treatment decreased postoperative atrial fibrillation (OR, 0.64; 95% CI, 0.43-0.95). We conclude that statin administration results in a reduction in the incidence of atrial fibrillation in patients who undergo cardiac surgery. Further research into the underlying mechanism can elucidate possible relationships between the dosage and type of statin used.

Journal article

Nagpal K, Ahmed K, Vats A, Yakoub D, James D, Ashrafian H, Darzi A, Moorthy K, Athanasiou Tet al., 2010, Is minimally invasive surgery beneficial in the management of esophageal cancer? A meta-analysis, Surg Endosc

INTRODUCTION: Open esophagectomy for cancer is a major oncological procedure, associated with significant morbidity and mortality. Recently, thoracoscopic procedures have offered a potentially advantageous alternative because of less operative trauma compared with thoracotomy. The aim of this study was to utilize meta-analysis to compare outcomes of open esophagectomy with those of minimally invasive esophagectomy (MIE) and hybrid minimally invasive esophagectomy (HMIE). METHODS: Literature search was performed using Medline, Embase, Cochrane Library, and Google Scholar databases for comparative studies assessing different techniques of esophagectomy. A random-effects model was used for meta-analysis, and heterogeneity was assessed. Primary outcomes of interest were 30-day mortality and anastomotic leak. Secondary outcomes included operative outcomes, other postoperative outcomes, and oncological outcomes in terms of lymph nodes retrieved. RESULTS: A total of 12 studies were included in the analysis. Studies included a total of 672 patients for MIE and HMIE, and 612 for open esophagectomy. There was no significant difference in 30-day mortality; however, MIE had lower blood loss, shorter hospital stay, and reduced total morbidity and respiratory complications. For all other outcomes, there was no significant difference between the two groups. CONCLUSION: Minimally invasive esophagectomy is a safe alternative to the open technique. Patients undergoing MIE may benefit from shorter hospital stay, and lower respiratory complications and total morbidity compared with open esophagectomy. Multicenter, prospective large randomized controlled trials are required to confirm these findings in order to base practice on sound clinical evidence.

Journal article

Ali E, Saso S, Ashrafian H, Athanasiou Tet al., 2010, Does a skeletonized or pedicled left internal thoracic artery give the best graft patency?, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 10, Pages: 97-104, ISSN: 1569-9293

Journal article

Ahmed K, Keeling AN, Fakhry M, Ashrafian H, Aggarwal R, Naughton PA, Darzi A, Cheshire N, Athanasiou T, Hamady Met al., 2010, Role of Virtual Reality Simulation in Teaching and Assessing Technical Skills in Endovascular Intervention, J Vasc Interv Radiol, Vol: 21

Journal article

Ashrafian H, Mortlock A, Athanasiou T, 2010, A Primer for Grant Applications, KEY TOPICS IN SURGICAL RESEARCH AND METHODOLOGY, Editors: Athanasiou, Debas, Darzi, Publisher: SPRINGER-VERLAG BERLIN, Pages: 579-586, ISBN: 978-3-540-71914-4

Book chapter

Ashrafian H, Rowland S, Athanasiou T, 2010, How to Recruit Patients in Surgical Studies, KEY TOPICS IN SURGICAL RESEARCH AND METHODOLOGY, Pages: 75-81

Journal article

Ashrafian H, Mayer E, Athanasiou T, 2010, Monitoring Trial Effects, KEY TOPICS IN SURGICAL RESEARCH AND METHODOLOGY, Pages: 67-73

Journal article

Ashrafian H, Athanasiou T, 2010, How to Read a Paper, KEY TOPICS IN SURGICAL RESEARCH AND METHODOLOGY, Editors: Athanasiou, Debas, Darzi, Publisher: SPRINGER-VERLAG BERLIN, Pages: 545-555, ISBN: 978-3-540-71914-4

Book chapter

Ahmed K, Ashrafian H, Paraskeva P, 2010, How to organize an educational research programme within an academic surgical unit?, Key Topics in Surgical Research and Methodology, Editors: Athanasiou, Debas, Darzi, Publisher: Springer, ISBN: 9783540719144

Book chapter

Ashrafian H, Ahmed K, Mayer E, 2010, An Ancient Case of Bifid Scrotum, Urol Int, Vol: 84, Pages: 112-112

2010;84:(DOI: 10.1159/000273477)

Journal article

Ahmed K, Rowland S, Patel V, Khan RS, Ashrafian H, Davies DC, Darzi A, Athanasiou T, Paraskeva PAet al., 2010, Is the structure of anatomy curriculum adequate for safe medical practice?, Surgeon, Vol: 8, Pages: 318-324, ISSN: 1479-666X

INTRODUCTION: Anatomy has been considered a core subject within the medical education curriculum. In the current setting of ever-changing diagnostic and treatment modalities, the opinion of both students and trainers is crucial for the design of an anatomy curriculum which fulfils the criteria required for safe medical practice. METHODS: Medical students, trainees and specialist trainee doctors and specialists from the London (England) area were surveyed to investigate the how curriculum changes have affected the relevance of anatomical knowledge to clinical practice and to identify recommendations for optimum teaching methods. The survey employed 5-point Likert scales and multiple-choice questions. Where the effect of training level was statistically significant (p < 0.05), post-hoc analysis was carried out using Mann-Whitney U tests. Significance levels were modified according to the Bonferroni method. RESULTS: Two hundred and twenty-eight individuals completed the survey giving a response rate of 53%. Medical students, trainees and specialists all agreed (mean Likert score 4.51, 4.79, 4.69 respectively) that knowledge of anatomy is important for medical practice. Most of the trainees (88.4%) and specialists (81.3%) used dissection to learn anatomy, but only 61.4% of medical students used this approach. Dissection was the most commonly recommended approach for learning anatomy across all the groups (41.7%-69.3%). CONCLUSIONS: Knowledge of anatomy is perceived to be important for safe clinical practice. Anatomy should be taught with other relevant system or clinical modules. Newer tools for anatomy teaching need further validation before incorporation into the curriculum.

Journal article

Ashrafian H, Ahmed K, Athanasiou T, 2010, The Ethics of Animal Research, Key Topics in Surgical Research and Methodology, Editors: Athanasiou, Debas, Darzi, Publisher: Springer, ISBN: 9783540719144

Book chapter

Ashrafian H, Rao C, Athanasiou T, 2009, Too much benchmarking Reply, LANCET, Vol: 374, Pages: 1963-1963, ISSN: 0140-6736

Journal article

Kokotsakis J, Lazopoulos G, Ashrafian H, Misthos P, Athanasiou T, Lioulias Aet al., 2009, Thoracoabdominal aneurysm repair using a four-branched thoracoabdominal graft: A case series, Cases Journal, Vol: 2, ISSN: 1757-1626

Revascularization of the visceral arteries during thoracoabdominal aneurysm repair is usually performed sequentially by an anastomosis between a prosthetic graft and an aortic patch. There are immediate operative risks such as bleeding and distortion. In the longer term, aneurysm, pseudoaneurysm and rupture may occur. These require reoperation and are associated with significant morbidity and mortality. We present our experience with Crawford IV thoracoabdominal aneurysm repair in four patients, using a prefabricated four-branched graft (Coselli graft). At two years there were no deaths, no complications and no vessel abnormalities on computed tomography. We recommend its use as the graft of choice in young patients with an aortic tissue disorder requiring total resection of the aortic wall at the level of the visceral vessels. © 2009 Kokotsakis et al; licensee Cases Network Ltd.

Journal article

Ashrafian H, Bueter M, Ahmed K, Suliman A, Bloom SR, Darzi A, Athanasiou Tet al., 2009, Metabolic surgery: an evolution through bariatric animal models, Obes Rev

Journal article

Saso S, Vecht JA, Rao C, Protopapas A, Ashrafian H, Leff D, Darzi A, Athanasiou Tet al., 2009, Statin Therapy May Influence the Incidence of Postoperative Atrial Fibrillation What Is the Evidence?, TEXAS HEART INSTITUTE JOURNAL, Vol: 36, Pages: 521-529, ISSN: 0730-2347

Journal article

Ali E, Saso S, Ashrafian H, Athanasiou Tet al., 2009, When harvested for Coronary Artery Bypass Graft Surgery, does a skeletonized or pedicled radial artery improve conduit patency?, Interact Cardiovasc Thorac Surg, 2010; 10(2):289-92

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Journal article

Ahmed K, Keeling A, Khan RS, Ashrafian H, Arora S, Nagpal K, Burrill J, Darzi A, Athanasiou T, Hamady Met al., 2009, What Does Competence Entail in Interventional Radiology?, Cardiovasc Intervent Radiol, ISSN: 0174-1551

Journal article

Ahmed K, Ashrafian H, 2009, Life-Long Learning for Physicians, Science, Vol: 326

Journal article

Aziz O, Skapinakis P, Rahman S, Rao C, Ashrafian H, Panesar SS, Darzi A, Foale R, Athanasiou Tet al., 2009, Behavioural interventions for smoking cessation in patients hospitalised for a major cardiovascular event, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 137, Pages: 171-174, ISSN: 0167-5273

Journal article

Ahmed K, Ashrafian H, Hanna GB, Darzi A, Athanasiou Tet al., 2009, Assessment of specialists in cardiovascular practice, Nature Rev Cardiol

Journal article

Ahmed K, Ashrafian H, 2009, Healthcare-biotech symbiosis, Nature Biotech, Vol: 27

Journal article

Ashrafian H, Sevdalis N, Athanasiou T, 2009, Evidence based surgery, Key Topics in Surgical Research and Methodology, Editors: Darzi, Athanasiou, Publisher: Springer Verlag, Pages: 9-26, ISBN: 9783540719144

Book chapter

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