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.
Increased downscaling of CMOS circuits with respect to feature size and threshold voltage has a result of dramatically increasing in leakage current. So, leakage power reduction is an important design issue for active and standby modes as long as the technology scaling increased. In this paper, a simultaneous active and standby energy optimization methodology is proposed for 22 nm sub-threshold CMOS circuits. In the first phase, we investigate the dual threshold voltage design for active energy per cycle minimization. A slack based genetic algorithm is proposed to find the optimal reverse body bias assignment to set of noncritical paths gates to ensure low active energy per cycle with the maximum allowable frequency at the optimal supply vo
... Show MoreIn this modern Internet era and the transition to IPv6, routing protocols must adjust to assist this transformation. RIPng, EIGRPv6 and OSPFv3 are the dominant IPv6 IGRP (Interior Gateway Routing Protocols). Selecting the best routing protocol among the available is a critical task, which depends upon the network requirement and performance parameters of different real time applications. The primary motivation of this paper is to estimate the performance of these protocols in real time applications. The evaluation is based on a number of criteria including: network convergence duration, Http Page Response Time, DB Query Response Time, IPv6 traffic dropped, video packet delay variation and video packet end to end de
... Show MoreThe present work aims to validate the experimental results of a new test rig built from scratch to evaluate the thermal behavior of the brake system with the numerical results of the transient thermal problem. The work was divided into two parts; in the first part, a three-dimensional finite-element solution of the transient thermal problem using a new developed 3D model of the brake system for the selected vehicle is SAIPA 131, while in the second part, the experimental test rig was built to achieve the necessary tests to find the temperature distribution during the braking process of the brake system. We obtained high agreement between the results of the new test rig with the numerical results based on the developed model of the brake
... Show MoreIn this paper, a methodology is presented for determining the stress and strain in structural concrete sections, also, for estimating the ultimate combination of axial forces and bending moments that produce failure. The structural concrete member may have a cross-section with an arbitrary configuration, the concrete region may consist of a set of subregions having different characteristics (i.e., different grades of concretes, or initially identical, but working with different stress-strain diagrams due to the effect of indirect reinforcement or the effect of confinement, etc.). This methodology is considering the tensile strain softening and tension stiffening of concrete in additio
In this work Nano crystalline (Cu2S) thin films pure and doped 3% Al with a thickness of 400±20 nm was precipitated by thermic steaming technicality on glass substrate beneath a vacuum of ~ 2 × 10− 6 mbar at R.T to survey the influence of doping and annealing after doping at 573 K for one hour on its structural, electrical and visual properties. Structural properties of these movies are attainment using X-ray variation (XRD) which showed Cu2S phase with polycrystalline in nature and forming hexagonal temple ,with the distinguish trend along the (220) grade, varying crystallites size from (42.1-62.06) nm after doping and annealing. AFM investigations of these films show that increase average grain size from 105.05 nm to 146.54 nm
... Show MoreObiovisly that the holy thresholds are directly related to Islam and Muslims and related to the general culture of the Islamic peoples. In terms of architecture, it is considered a distinctive architectural scene that reviews the history of this origin and its architectural styles. Recently, with the increase in the number of pilgrims and visitors to the holy shrines, there is a need to develop and expand the buildings and provide them with services and introduce modern technology. The building of the holy thresholds consists of a number of functional design indicators: The general problem of research is that there is no clear theoretical framework for the design indicators for the development of the holy shrines according to the functio
... Show MoreSamples of Iraqi bentonitic sediments, representing local montmorillonite brought from Traifawi region near the Syrian border. Mineralogical the samples were characterized as low grade of Ca-smectite, particle size, chemical analysis, XRD, and BET surface area analyses of the samples were carried out to examine the structure of bentonite before and after acid activation. The goal is to prepare a bleaching earth for edible oil production. Iraqi Bentonite was beneficiated and activated by series of physical and chemical steps, using 4N & 6N concentration of hydrochloric acid and at a temperature of 70-80 ° C. Surface area and pore volume of the samples were determined to assess the bleaching power