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Afferent loop syndrome may result from volvulus, recurring cancer, stomal stenosis, adhesions, kinking at the anastomotic site, internal herniation, and gastrointestinal stones. [1] Laboratory investigations can help diagnose afferent loop syndrome, but imaging scans are required for a confirmation diagnosis. [2]
Severe stenosis constitutes a diameter loss of 2/3 or more—a greater-than-90% loss of cross-sectional area. [5] To more accurately determine the severity of stenosis, interventional cardiologists may also employ intravascular ultrasound , which can determine the severity and provide information on the composition of the atheromatous plaque.
Pearson and Gullane would later report their success using this procedure over the ensuing 22 years in 80 consecutive adults with benign subglottic stenosis. [13] Impressed by the results of Gerwat and Bryce, Monnier, Savary, and Chapuis performed the first cricoid resection with primary anastomosis in a child in 1978. [14]
Laryngotracheal stenosis is an umbrella term for a wide and heterogeneous group of very rare conditions. The population incidence of adult post-intubation laryngotracheal stenosis which is the commonest benign sub-type of this condition is approximately 1 in 200,000 adults per year. [10] The main causes of adult laryngotracheal stenosis are:
Side-to-side anastomosis and end-to-side anastomosis are two procedures that can be done. Side-to-side anastomosis is preferred as the distal CBD blood supply is poor and more suitable to the laparoscopic approach, which requires limited anterior CBD dissection. Performing an end-to-side anastomosis risks ischemia and recurrent stenosis. [8]
In 1958, William Glenn reported a successful superior vena cava to right pulmonary artery anastomosis (Glenn procedure) for tricuspid atresia in the New England Journal of Medicine. [12] The bidirectional Glenn is a modification where the SVC connects proximally to the bifurcation of the pulmonary arteries. [ 13 ]
Vein skeleton of a Hydrangea leaf showing anastomoses of veins. An anastomosis (/ ə ˌ n æ s t ə ˈ m oʊ s ɪ s /, pl.: anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf veins, or streams.
One of the reasons affecting the rate of stenosis could be the anastomotic angle. [3] [4] In computational fluid dynamics study, the ideal anastomotic angle should be less than 30 degrees to ensure laminar flow of the blood, thus prolong the endothelial cell survival, and prevent smooth muscle proliferation within vessel wall, and clogging the ...