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.
In this work, a class of stochastically perturbed differential systems with standard Brownian motion of ordinary unperturbed differential system is considered and studied. The necessary conditions for the existence of a unique solution of the stochastic perturbed semi-linear system of differential equations are suggested and supported by concluding remarks. Some theoretical results concerning the mean square exponential stability of the nominal unperturbed deterministic differential system and its equivalent stochastically perturbed system with the deterministic and stochastic process as a random noise have been stated and proved. The proofs of the obtained results are based on using the stochastic quadratic Lyapunov function meth
... Show MoreFeedback on students’ assignments can be done in many different ways. Nowadays, the growing number of students at universities has increased the burden on the instructors to give feedback on students’ writings quickly and efficiently. As such, new methods of modern online automated feedback tools, such as Hemingway app and ecree,are used to assist and help instructors. Hence, this research is an explanatory study to examine the effect of using the online automated feedback on some Iraqi EFL learners’ writings at the university level. The study comprised 60 students enrolled in an English language course at the University of Anbar. They were divided randomly into two groups, experi
... Show MoreMultispectral remote sensing image segmentation can be achieved using a multithresholding technique. This paper studies the effect of changing the window size of the two dimensional (2D) fast Otsu algorithm that presented by Zhang. From the results, it shown that this method behaves as a search machine for the valleys (an automatic threshold), between the gray levels of the histogram with changing the size of slide window.
Keywords Image Segmentation, (2D) Fast Otsu method, Multithresholding, Automatic thresholding, (2D) histogram image.
The nanostructured MnO2 /carbon fiber (CF) composite electrode was prepared using the anodic electrodeposition process. The crystal structure and morphology of MnO2 particles were determined with X-ray diffraction and field-emission scanning electron microscopy. The electrosorptive properties of the prepared electrode were investigated in the removal of cadmium ions from aqueous solution, and the effect of pH, cell voltage, and ionic strength was optimized and modeled using the response surface methodology combined with Box–Behnken design. The results confirm that the optimum conditions to remove Cd(II) ions were: pH of 6.03, a voltage of 2.77 V, and NaCl concentration of 3 g/L. The experimental results showed a good fit for the Freundli
... Show MoreThe research aims at clarifying the relationship between innovative marketing skills and broad recommendation as a vital and important issue for organizations in general and service organizations in particular to demonstrate how innovative marketing skills contribute to broad adoption and to determine the relationship between interdependence and the impact of innovative marketing skills on the broad recommendation. Some questions are posed by the research problem. Is there a clear awareness among individuals in the company about the concept of marketing marketing skills and how do innovative marketing skills affect the broad recommendation of the surveyed company? How innovative marketing skills relate to the broad recommendation
... Show MoreThis paper presents the non-linear finite element method to study the behavior of four reinforced rectangular concrete MD beams with web circular openings tested under two-point load. The numerical finite elements methods have been used in a much more practical way to achieve approximate solutions for more complex problems. The ABAQUS /CAE is chosen to explore the behavior of MD beams. This paper also studies, the effect of both size and shape of the circular apertures of MD beams. The strengthening technique that used in this paper is externally strengthening using CFRP around the opening in the MD beams. The numerical results were compared to the experimental results in terms of ultimate load failure and displace
... Show MoreThis study aimed to obtain an isolate of a mold that has well characteristic for production of citric acid from raw materials available locally by solid-state fermentation and determination of the optimum conditions for production .Fourteen mold isolates producing acid were obtained from different sources, involved decayed fruits and soils. These isolates were subjected to initial qualitative screening followed by secondary quantitative screening In secondary screening a method combined between the submerged fermentation and solid-state fermentation was followed using a piece of sponge saturated by nutrients required for growth and production of acid. It was found that the isolate of A7 was the highest producer for citric acid tha
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