Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI between May 2009 and May 2010 in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassryia cardiac center were prospectively analyzed . The clinical data were collected using the patients files and angiographic data by review of their films.
Results: There were (80) Patients with CTO ,They included 62 men (77.5%) and 18 women (22.5%) ,Age range 36-76 year with mean age 55±8.75 and male to female ratio was 3:1 .The procedural success rate of PCI was 66 patients (82.5%). All 23patients(100%) with lesionlength less than 15 mm had successful PCI compared to 43 out of 57 patients in whom the lesion was more than 15mm (75.4%) p value < 0.01. The procedure was successful in 54 patients out of 60 with tapered stump(90%) compared to 12 out of 20 patients with abrupt stump(60%) p value <0.005.In CTO lesion with angulations less than 45 degree ,the procedure was successful in 27 patients out of 28 (96.4%)compared to 39 out of 52 patients in whom the angulations was more than 45 degree 52(75%) p value<0.01. The most common cause of procedural un success was inability of guide wire crossing through the totally occluded segments which represented 11(78.5%), Inability to cross the lesion with a balloon in 2 patients(14.2%) and inability to dilate balloon in one patient (7.1%) P<0.001.
Conclusion: Percutaneous coronary intervention of chronic total occlusion is an effective therapeutic procedure with high success rate 82.5%. The length of chronic total occlusion ,degree of angulations and stump morphology are strong predictors of success procedure.
The study aimed to reveal the role of social capital represented by its dimensions (structural, relational, and cognitive) in strengthening the management of excellence in Azadi Hospital / Duhok. In order to reach the goal of the study, the study variables were highlighted in theory through framing concepts and literary contributions for researchers in this field, In the field, the questionnaire was used as a basic tool to collect data from the individuals in the research sample who were represented by officials and individuals working from administrators and technicians, as (120) forms were distributed to the respondents, and (110) were retrieved from them in a way that is valid for analysis. Several statistical methods have bee
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El horóscopo que es una predicción deducida de la posición de los astros del sistema solar y de los signos de Zodiaco, intenta no sólo predecir el futuro, sino también influir en el comportamiento del lector, orientándolo para que actúe adecuadamente y la invitación a actuar ante ese futuro que se aconseja mediante imperativos, perífrasis y otros recursos lingüísticos. Los horóscopos se caracterizan por su gran popularidad que existen en periódico o revista en columnas enteras dedicadas al tema, en donde se detallan la influencia que tendrá el día o el mes de cada uno de los signos correspondientes al zodíaco, siempre teniendo en cuenta la posici
... Show MoreRate of penetration plays a vital role in field development process because the drilling operation is expensive and include the cost of equipment and materials used during the penetration of rock and efforts of the crew in order to complete the well without major problems. It’s important to finish the well as soon as possible to reduce the expenditures. So, knowing the rate of penetration in the area that is going to be drilled will help in speculation of the cost and that will lead to optimize drilling outgoings. In this research, an intelligent model was built using artificial intelligence to achieve this goal. The model was built using adaptive neuro fuzzy inference system to predict the rate of penetration in
... Show MoreThis study investigates the implementation of Taguchi design in the estimation of minimum corrosion rate of mild-steel in cooling tower that uses saline solution of different concentration. The experiments were set on the basis of Taguchi’s L16 orthogonal array. The runs were carried out under different condition such as inlet concentration of saline solution, temperature, and flowrate. The Signal-to- Noise ratio and ANOVA analysis were used to define the impact of cooling tower working conditions on the corrosion rate. A regression had been modelled and optimized to identify the optimum level for the working parameters that had been founded to be 13%NaCl, 35ᴼC, and 1 l/min. Also a confirmation run to establish the p
... Show MoreThis research aims to test the causal relationship long-and short-run between the price of gold the global crude oil price and the exchange rate of the dollar and how you can take advantage of the nature of this relationship, particularly in the Arab oil states that achieve huge surpluses, including Iraq and how to keep on the purchasing power of these surpluses or reduce the levels of risk.
The problem is that the Arab oil countries, adversely affected, as a result of that relationship, due to the fact that its role confined to the sale of crude oil only. They do not have control in the dollar, then they are not able to take advantage of its impact on the price of gold the fact that gold is effective pr
... Show More: Summary The establishment of the modern Iraqi state necessitated the establishment of diplomatic relations with neighboring countries. However, during the British Mandate period, these relations remained under the management of the British Embassy, which assumed responsibility for Iraq's foreign affairs. As the political situation evolved, the Iraqi Ministry of Foreign Affairs began making strenuous efforts to build a competent and effective diplomatic apparatus. Iraqi diplomatic representatives played an active role in strengthening and developing Iraq's foreign relations by implementing the Ministry of Foreign Affairs' directives, which focused on monitoring political, economic, and social developments in neighboring countries. This app
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