Recent ucsdsom_srg_oapdeposits items

Kidney Transplantation in Two Highly Sensitized Candidates after CAR T-Cell Therapy.

Wed, 17 Jun 2026 00:00:00 +0000

HLA sensitization poses a major challenge to kidney transplantation for patients with end-stage kidney disease, especially for highly sensitized candidates. Attempts at antibody elimination (desensitization) have had inconsistent efficacy and have often failed to produce sustained reductions in anti-HLA antibodies in patients with the highest level of sensitization (calculated panel-reactive antibody score, ≥99.9%). We now report the results for the safety run-in cohort of a multicenter phase 1 clinical study evaluating the safety and efficacy of combined CD19-targeted and B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR) T cells in eliminating the cellular sources of preformed anti-HLA antibodies (ClinicalTrials.gov number, NCT06056102). Kidney transplantation was performed in two highly sensitized candidates after desensitization with the use of dual CAR T-cell therapy.

Decision-Making in Pleural Drainage Following Lung Resection in Children: A Western Pediatric Surgery Research Consortium Survey

Thu, 28 May 2026 00:00:00 +0000

INTRODUCTION: Studies of adults undergoing lung resection indicated that selective omission of pleural drains is safe and advantageous. Significant practice variation exists for pleural drainage practices for children undergoing lung resection. We surveyed pediatric surgeons in a 10-hospital research consortium to understand decision-making for placement of pleural drains following lung resection in children. METHODS: Faculty surgeons at the 10 member institutions of the Western Pediatric Surgery Research Consortium completed questionnaires using a REDCap survey platform. Descriptive statistics and bivariate analyses were used to characterize responses regarding indications and management of pleural drains following lung resection in pediatric patients. RESULTS: We received 96 responses from 109 surgeons (88 %). Most surgeons agreed that use of a pleural drain after lung resection contributes to post-operative pain, increases narcotic use, and prolongs hospitalization. Opinions...

Pleural drain placement following lung resection in children: A prospective observational study of the Western Pediatric Surgery Research Consortium

Thu, 28 May 2026 00:00:00 +0000

PURPOSE: Pleural drains are used routinely after thoracic surgery in children despite evidence that drainage is not always necessary. The purpose of this study was to assess the necessity of intraoperative drain placement after resectional lung surgery in children, provide a contemporary characterization of the use of pleural drains, and evaluate the utility of intraoperative air leak testing. METHODS: A multi-institutional prospective cohort study was performed at 10 free-standing children's hospitals in the United States from 2023 to 2024. Patients ≤18 years old who underwent open or thoracoscopic wedge resection or lobectomy were included. Patients undergoing operation for spontaneous pneumothorax or trauma, those on extra-corporeal life support, those undergoing bi-lobectomy or pneumonectomy, and those undergoing reoperation in the affected hemithorax were excluded. Operative parameters, intra-operative air leak, length of post-operative drain placement, and number of post-operative...

Comparison of Postoperative Antibiotic Protocols for Pediatric Complicated Appendicitis: A Western Pediatric Surgery Research Consortium Study

Thu, 28 May 2026 00:00:00 +0000

BACKGROUND: There is no consensus on the appropriate duration of postoperative antibiotics for complicated appendicitis in children. Commonly used antibiotic endpoints include normalization of white blood cell count (WBC) or completion of a minimum number of prespecified treatment days. We compared clinical outcomes resulting from varying postoperative antibiotic protocols for complicated appendicitis in children. METHODS: National Surgical Quality Improvement Program Pediatric (NSQIP-P) data from nine children's hospitals was used to identify a retrospective cohort of children (<18 years) who underwent laparoscopic appendectomy from 2021 to 2023 with intraoperative findings of complicated appendicitis. Participating hospitals were classified into four groups based on discharge protocol: 1) no discharge antibiotics, 2) oral antibiotics for elevated WBC on the day of discharge, 3) oral antibiotics to complete a minimum number of total antibiotic days, and 4) routine discharge...

Developmental organization of sensory and sympathetic ganglia

Thu, 9 Apr 2026 00:00:00 +0000

The neural crest generates a broad spectrum of cell types that migrate across the body plan to populate multiple tissues1. However, the relationship between lineages of neural crest derivatives remains unclear, and the extent to which neural crest cells delaminated from the neural tube have specified fates remains debated. Here, leveraging CRISPR barcoding in mice and mosaic variant barcode analysis in humans, we demonstrate robust bilateral progenitor clonal spread of neural crest progenitors along the rostrocaudal axis but limited clonal overlap between sensory and sympathetic lineages. Computational modelling of mosaic variants suggests that most neural crest cells show strong fate restriction before delamination. Real-time imaging of quail embryos further shows a fibroblast-growth-factor-dependent rostrocaudal dispersion of neural crest cells across multiple axial levels. These findings support a model in which neural crest fate bias predominantly emerges within the neural...

War at Sea: Burn Care Challenges—Past, Present and Future

Thu, 26 Mar 2026 00:00:00 +0000

Throughout history, seafarers have been exposed to potential thermal injuries during naval warfare; however, injury prevention, including advances in personal protective equipment, has saved lives. Thankfully, burn injuries have decreased over time, which has resulted in a significant clinical skills gap. Ships with only Role 1 (no surgical capability) assets have worse outcomes after burn injury compared to those with Role 2 (surgical capability) assets. To prepare for future burn care challenges during a war at sea, Military Medicine must re-learn the lessons of World War I and World War II. Burn injuries do not occur in isolation during war and are associated with concomitant traumatic injuries. To care for burn casualties at sea, there is an urgent need to increase the availability of whole blood and dried plasma, resuscitation fluids that were ubiquitous throughout the naval force during World War II for both hemorrhagic and burn shock resuscitation. Furthermore, those providing...

Management of a common hepatic artery pseudoaneurysm after blunt trauma

Thu, 26 Mar 2026 00:00:00 +0000

Management of a common hepatic artery pseudoaneurysm after blunt trauma

From fellowship to the frontline: A survey of military trauma training experience by the Military Deployment Readiness Assessment of Fellowship Training (DRAFT) Task Force.

Thu, 26 Mar 2026 00:00:00 +0000

BACKGROUND: Military trauma/surgical critical care (T/SCC) surgeons perform both clinical "inside-the-tent" (ITT) and leadership/administrative "outside-the-tent" (OTT) responsibilities during forward deployments. Despite these demands, fellowship programs lack a standardized curriculum addressing the full spectrum of military-specific requirements. This study evaluates military T/SCC surgeons' perceptions of training quality, satisfaction, and confidence in managing deployment trauma situations, and readiness to assume leadership roles. METHODS: A survey was distributed to all current military T/SCC fellows and attendings to evaluate their perception of ITT and OTT skill training during fellowship. Respondents reported their satisfaction with fellowship training, as well as their confidence, satisfaction, and frequency with which they practiced on ITT and OTT skills. Attendings were additionally asked how often they utilized OTT skills and assumed key OTT leadership positions,...

Brief report on the development of hemorrhagic pericardial effusion after thoracic surgery for traumatic injuries

Thu, 26 Mar 2026 00:00:00 +0000

Introduction: Hemorrhagic pericardial effusion (HPE) is a rare but life-threatening diagnosis that may occur after thoracic trauma. Previous reports have concentrated on delayed HPE in those who did not require initial surgical intervention for their traumatic injuries. In this report, we identify and characterize the phenomenon of HPE after emergent thoracic surgery for trauma. Methods: This is a retrospective review of patients who required emergent thoracic surgery for trauma at a level 1 trauma center from 2017 to 2021. Using the institutional trauma database, demographics, injury characteristics, and outcomes were compared between patients with HPE and those without HPE after thoracic surgery for trauma. Results: Ninety-one patients were identified who underwent emergent thoracic surgery for trauma. Most were young men who sustained a penetrating thoracic injury. Seven patients (7.7%) went on to develop HPE. Patients who developed HPE were younger (18 vs. 32 years, p=0.034),...

REBOA in shocked penetrating abdominal trauma patients: impact on outcomes

Thu, 26 Mar 2026 00:00:00 +0000

Introduction: The role of resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma is debated. We hypothesized that the use of REBOA for patients presenting in shock after penetrating abdominal trauma is associated with delay to laparotomy and increased mortality. Study design: We used 2017-2021 Trauma Quality Improvement Project data to identify adult (≥16 years) penetrating abdominal trauma patients with systolic blood pressure (SBP) ≤90 mm Hg undergoing laparotomy. REBOA was defined by International Classification of Diseases-10 code, with a procedure timestamp preceding or simultaneous to laparotomy incision. We propensity score matched REBOA to non-REBOA patients on demographics, mechanism, injury characteristics and severity, solid organ injury, abdominal vascular injury, SBP, heart rate, and Glasgow Coma Scale motor score. Outcomes were time to incision, transfusion requirements, complications, and in-hospital mortality. We additionally performed a survival...

Surgeon leadership in trauma resuscitation requires a competency-based multimodal training framework

Thu, 26 Mar 2026 00:00:00 +0000

Effective leadership during trauma resuscitation is a determinant of team performance and patient outcomes, yet existing training curricula remain procedure-centric and do not explicitly address the leadership domain. A structured, competency-based framework tailored to the resuscitation context may support more consistent training, evaluation, and entrustment of emerging trauma leaders. A narrative review of the literature was conducted across MEDLINE, Embase and Scopus using terms related to trauma, leadership, non-technical skills and competency frameworks. Relevant publications were categorized into: (1) leadership theory and styles; (2) non-technical skills frameworks; (3) trauma resuscitation education and assessment and (4) high-reliability team training from allied domains. Concepts were synthesized to derive a set of core competencies for trauma resuscitation leadership. Five interdependent competencies were identified: (1) adaptive leadership style matched to clinical...

Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative

Thu, 26 Mar 2026 00:00:00 +0000

Objectives: Percutaneously placed small-bore (14 Fr) catheters and pleural lavage have emerged independently as innovative approaches to hemothorax management. This report describes techniques for combining percutaneous thoracostomy with pleural lavage and presents results from a performance improvement series of patients managed with percutaneous thoracostomy with immediate lavage. Methods: This was a prospective performance improvement series of patients treated at a level 1 trauma center with percutaneous thoracostomy and immediate lavage between April 2021 and May 2023. Results: Percutaneous thoracostomy with immediate lavage was used to treat nine hemodynamically normal patients with acute hemothorax. Injuries included both blunt and penetrating mechanisms. 56% of patients presented immediately after injury, and 44% presented in a delayed fashion ranging from 2 to 26 days after injury. Median length of stay was 6 days (IQR 6, 9). Seven patients were discharged home in stable...

Venous shunting and limb outcomes in military lower extremity combined arterial and venous injuries

Thu, 26 Mar 2026 00:00:00 +0000

Introduction: Combined arterial and venous lower extremity (LE) injuries present complex management challenges. Temporary arterial shunting is widely accepted, but vein shunting is not well studied. We examined the influence of vein shunting on limb outcomes in military femoropopliteal arterial and venous combined injuries. Methods: A retrospective cohort study of Iraq and Afghanistan LE vascular injuries from 2004-2012 was performed and combined arterial and venous femoropopliteal injuries selected. Vein shunted and non-vein shunted groups were identified and pertinent variables compared. Results: Of 135 arteriovenous injuries, 61 (45%) had vein ligation (5 after shunting), leaving 74 injuries undergoing venous repair (37 grafts (3 synthetic), 34 local repairs, 3 patches). The vein was shunted in 16 (22%). The shunt and no shunt cohorts had similar demographics, mechanism (70% blast), and ISS (median 18, IQR 10-26). Tourniquets and fasciotomy were used equally. Venous shunts...

Primary Patency in Drug-Eluting Stenting versus Bypass for Femoropopliteal Occlusive Disease

Wed, 25 Feb 2026 00:00:00 +0000

INTRODUCTION: Numerous studies have compared the outcomes of bypass and bare-metal stent in the management of femoropopliteal occlusive disease. However, the available evidence has become scarce since the advent of paclitaxel drug-eluting stents (DESs). This study endeavors to assess and contrast the intermediate-termS real-world results of employing DES and bypass techniques in the treatment of individuals afflicted with femoropopliteal occlusive disease. MATERIALS AND METHODS: We identified all patients who underwent femoropopliteal revascularization at a single institution from January 2012 to December 2017. In this group, we selected all patients who received drug-eluting stents or underwent bypass using autogenous vein. We compared the primary patency, overall survival, and limb salvage at 2 y between the two groups. A comparison between the two groups within Trans-Atlantic Inter-Society Consensus (TASC) II subgroups was also performed. Multivariate Cox regression models...

On the Independence Assumption in Meta-analyses of Registry-Derived TCAR and TFCAS Outcomes

Wed, 25 Feb 2026 00:00:00 +0000

On the Independence Assumption in Meta-analyses of Registry-Derived TCAR and TFCAS Outcomes

3. Predictors of Surgical Site Infection Following Infra-Inguinal Bypass Surgery

Wed, 25 Feb 2026 00:00:00 +0000

3. Predictors of Surgical Site Infection Following Infra-Inguinal Bypass Surgery

Outcomes After Infrainguinal Interventions For Intermittent Claudication In Patients With End Stage Renal Disease Are Poor

Wed, 25 Feb 2026 00:00:00 +0000

INTRODUCTION: Intermittent claudication (IC) interventions are predicated on safety, durability, and long-term expected benefit. Patients with end stage renal disease (ESRD) have higher risk of complications after many surgical procedures and have lower overall survival. Our goal was to assess perioperative and 1-year outcomes of IC interventions in patients with ESRD. METHODS: The Vascular Quality Initiative was queried from 2010-2020 for peripheral vascular interventions (PVI) and infrainguinal bypasses (IIB) for IC. Demographics, comorbidities, procedural details, and outcomes were analyzed in patients with and without ESRD. RESULTS: There were 83698 PVI (2% ESRD and 98% non-ESRD) and 10935 IIB (1.2% ESRD and 98.8% non-ESRD) performed for IC. For PVI, ESRD patients more often underwent femoropopliteal (65.1% vs. 59.5%) and infrapopliteal (26.5% vs. 10.1%), and less often iliac interventions (32.1% vs. 46.4%) (all P<.001). There were no differences in access site complications,...

Artificial Intelligence and Machine Learning for Evaluation of Abdominal Aortic Aneurysm Rupture Risk.

Wed, 25 Feb 2026 00:00:00 +0000

Artificial Intelligence and Machine Learning for Evaluation of Abdominal Aortic Aneurysm Rupture Risk.

Impact of Conversion from Local/Regional to General Anesthesia on Outcomes in Transcarotid Artery Revascularization

Wed, 25 Feb 2026 00:00:00 +0000

Background This study evaluates impact of converting from local to general anesthesia on Transcarotid Artery Revascularization (TCAR) outcomes and identifies risk factors predictive of conversions. Methods 58,960 TCAR cases from the Vascular Quality Initiative (2018–2024) were categorized by anesthesia type: 6,831 local/regional (LRA), 51,851 general (GA), and 278 conversions from LRA to GA. In-hospital outcomes were compared using multivariate logistic regression, with stroke/death as the primary endpoint. Preoperative predictors of conversion were also assessed. Results Converted patients were oldest, more often obese, and more likely to undergo urgent procedures. Compared to LRA, conversion was associated with increased odds of in-hospital stroke/death (aOR = 3.01; 95% CI, 1.54-5.36; P < 0.001), stroke/death/MI (aOR = 2.92; 95% CI, 1.58-5.00; P < 0.001), and prolonged hospital stay (aOR = 1.38; 95% CI, 1.05-1.80; P = 0.020). Compared to GA, converted patients had higher...

Limited Preoperative Functionality Is Associated With Worse 30-D Mortality and Heart Failure After Carotid Artery Stenting

Wed, 25 Feb 2026 00:00:00 +0000

INTRODUCTION: Carotid artery stenting is indicated in patients with significant carotid artery stenosis who are high risk for carotid endarterectomy. Patients who are nonambulatory before surgery are considered high risk for carotid revascularization. However, the effect of preoperative ambulatory status on outcomes has not been well established. We sought to use the Vascular Quality Initiative (VQI) multi-institutional database to evaluate the early outcomes of carotid artery stenting stratified by the preoperative ambulatory status. METHODS: Patients included were nonemergent cases performed in participating VQI centers from 2016 to 2021. The study cohort was divided into two groups: full-functionality patients with full, light work, or self-care, and limited-functionality (LF) patients with assisted care or bed-bound. We used propensity scores by stratification matching on 29 demographic and preoperative clinical characteristics to obtain similar patient characteristics across...

Impact Of Prophylactic Postoperative Vasopressors On Outcomes Of Patients Undergoing Thoracic Endovascular Aortic Repair

Wed, 25 Feb 2026 00:00:00 +0000

Background Prophylactic postoperative vasopressors (PPV) are used to induce hemodynamic augmentation to prevent spinal cord ischemia (SCI) in patients undergoing thoracic endovascular aortic repair (TEVAR). However, the scientific evidence on its effectiveness and safety is limited. This study aims to investigate the safety and effectiveness of PPV in patients undergoing TEVAR in a multi-institutional real-world setting. Methods All TEVAR patients in the Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) database between March 1, 2012, and January 28, 2023, were identified. Univariable and multivariable analyses were performed to assess the association between the use of PPV and the rates of postoperative 30-day mortality, Major Adverse Cardiovascular Events (MACE, defined as new onset of postoperative myocardial infarction (MI), congestive heart failure (CHF), dysrhythmias, or stroke), SCI, and other adverse events for patients undergoing TEVAR. Results Out...

Expanding Access to Vascular Imaging: Preliminary Results from the Development of a Remote Surveillance Device

Wed, 25 Feb 2026 00:00:00 +0000

Introduction/Objectives Patients undergoing surgical procedures for peripheral artery disease and carotid artery stenosis are recommended to undergo surveillance imaging at regular intervals. With > 250,000 patients undergoing interventions for both annually, the number of patients requiring interval surveillance increases in parallel, placing strain on an already overburdened health system. In this study we evaluated the performance of a novel ultrasound platform prototype built for remote ultrasound surveillance. Methods The prototype duplex ultrasound device was developed by a team of engineers and utilizes color flow images to detect the vessel for flow velocity measurements. The device was tested on 28 healthy volunteers. The results of spectral flow from the device were compared to standard of care ultrasound measurements of the CFA, SFA, ICA and CCA. Results The mean absolute difference between the prototype ultrasound and standard of care device for peak systolic velocity...

Active Surveillance of Ductal Carcinoma In-Situ

Thu, 29 Jan 2026 00:00:00 +0000

Purpose of ReviewTailoring treatment strategies to the biological features of invasive disease and the individual needs and preference of each patient has transformed the way we manage breast cancer. This article calls for a similar shift in the management paradigm of ductal carcinoma in situ (DCIS) from a uniform treatment model toward a risk-stratified stepwise approach that aligns with the heterogeneous nature of the disease to avoid overtreatment.Recent FindingsMost DCIS lesions are hormone receptor positive, and only a subset have a risk for progression to invasive cancer. Early results from observational and clinical studies indicate that active surveillance is a safe and feasible alternative to upfront surgical treatment for low-risk DCIS. Ongoing clinical trials like RECAST will further inform and refine strategies for optimal management of this condition.SummaryThe integration of risk-adapted management strategies, endocrine risk-reducing interventions, and advanced imaging...

Relative Effects of Brachytherapy and Beam Radiation for DCIS on Subsequent Invasive Events

Thu, 29 Jan 2026 00:00:00 +0000

Background/Objectives: Patients with a diagnosis of ductal carcinoma in situ (DCIS) were poorly represented in the four trials that established the efficacy of partial relative to whole-breast irradiation. In contrast to invasive cancers, patients with DCIS are equally likely to have a subsequent ipsilateral invasive event in a different site of the breast from their initial DCIS lesion as they are at the same site. We aim to compare the efficacy of a type of partial-breast irradiation, brachytherapy, to external-beam radiation in the reduction of subsequent invasive cancers. Methods: Women diagnosed with a first breast cancer of unilateral DCIS treated with breast-conserving surgery without endocrine therapy were identified in SEER. Matching was performed 1:2 from patients receiving brachytherapy to patients receiving external-beam radiation or no radiation. External-beam radiation was assumed to be whole-breast radiation for the majority of patients in this cohort...

Immunomodulation of Pancreatic Cancer via Inhibition of SUMOylation and CD155/TIGIT Pathway.

Mon, 8 Dec 2025 00:00:00 +0000

Pancreatic ductal adenocarcinoma (PDAC) is the deadliest major cancer and has a profoundly immunosuppressive tumor microenvironment (TME). Previous studies have shown that inhibition of the E1 enzyme, which catalyzes the small ubiquitin-like modifiers (SUMO), with the small molecule TAK-981, can reprogram the TME to enhance immune activation and suppress tumor growth. We found that the CD-155/TIGIT pathway, a key regulator of immune evasion in PDAC, is influenced by SUMOylation. We hypothesized that the combination of SUMO E1 and TIGIT inhibition would synergistically induce anti-tumor immune effects. We used a clinically relevant orthotopic mouse model that consistently develops liver metastases to study this combination therapy alone and in the perioperative setting with surgical resection. The combination of SUMO E1 and TIGIT inhibition significantly prolonged survival. Complete responders exhibited protective immunity and enhanced T cell reactivity to model-specific alloantigens....

Effectiveness and Safety of Irreversible Electroporation When Used for the Ablation of Stage 3 Pancreatic Adenocarcinoma: Initial Results from the DIRECT Registry Study

Mon, 8 Dec 2025 00:00:00 +0000

BACKGROUND/OBJECTIVES: Overall survival for patients with Stage 3 pancreatic ductal adenocarcinoma (PDAC) remains limited, with a median survival of 12 to 15 months. Irreversible electroporation (IRE) is a local tumor ablation method that induces cancerous cell death by disrupting cell membrane homeostasis. The DIRECT Registry study was designed to assess the effectiveness and safety of IRE when combined with standard of care (SOC) treatment for Stage 3 PDAC versus SOC alone in a real-world setting after at least 3 months of induction chemotherapy; Methods: Patients with Stage 3 PDAC treated with IRE plus SOC or SOC alone were prospectively enrolled in a multicenter registry study. Enrollment required 3 months of active multi-agent chemotherapy with no progression before enrollment. Endpoints were 30- and 90-day mortality and adverse events (AEs). RESULTS: Eighty-seven IRE and 27 SOC subjects were enrolled in the registry. Mean ages were 64.0 ± 8.4 and 66.4 ± 9.9 years, and mean...

Health Policy Advocacy: Navigating Personal, Professional, and Organizational Politics

Wed, 26 Nov 2025 00:00:00 +0000

Health Policy Advocacy: Navigating Personal, Professional, and Organizational Politics

Safely Debriefing Unexpected Simulation Death: How We Did It

Wed, 26 Nov 2025 00:00:00 +0000

PURPOSE: Medical students feel inadequately prepared to cope with patient death. Simulation training may provide learners with the opportunity to experience death in a safe environment with a structured debriefing. METHODS: Nineteen fourth-year medical students who matched into surgical specialties participated in a 2-week surgical intern preparatory course. During an individual surgical decision-making simulation, 6 learners experienced unexpected patient death at the hands of a facilitator who deviated from the simulation script. Subjectively, these learners displayed high anxiety before the debriefing. Objectively, their self-reported anxiety after the structured debriefing was similar to the self-reported anxiety of learners who did not experience simulation death. RESULTS: We formalized a bi-directional debriefing instrument using the Gather Analyze Summarize (GAS) model as a framework. We recognized that learners who experienced simulation death need to debrief on 2 aspects...

Differential change in extraocular muscle volume after teprotumumab for thyroid eye disease

Thu, 6 Nov 2025 00:00:00 +0000

PURPOSE: To evaluate the effects of teprotumumab on individual extraocular muscle (EOM) volume and proptosis in thyroid eye disease (TED). METHODS: A retrospective review was performed using exophthalmometry, clinical activity score (CAS), and orbital imaging before and after teprotumumab treatment. The lateral rectus (LR), medial rectus (MR), superior rectus (SR), inferior rectus (IR) muscles, and the globe were manually segmented individually. Individual and total EOM volumes were calculated and compared between pre- and post-treatment magnetic resonance imaging (MRI). RESULTS: Mean proptosis reduction after teprotumumab treatment was 3.69 mm (95% CI: 2.82, 4.17, p < 0.001), with an improvement in all orbits. Significant muscle volume reductions occurred in the MR (-20%, p < 0.001) and IR (-28%, p = 0.002) but not the LR (-11%, p = 0.063) or SR (-19%, p = 0.053). Total EOM volume decreased by 20%, while globe volume remained unchanged....

The Predictors of Prolonged Length of Stay Following Elective Aortobifemoral Bypass for Aortoiliac Occlusive Disease