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.
Despite the importance of sustainable development and its dimensions in developing performance and supporting competitive advantage in economic units, there is a gap and lack of coordination between Combined Assurance providers (management, internal audit, external audit) to report on sustainable development, and the research aims to propose a model for the Combined Assurance report to achieve development sustainable development in the Iraqi economic units, especially the Baghdad Municipality, enables assurance providers to coordinate efforts that lead to the achievement of Combined Assurance, The research found the proposed model for the Combined Assurance report in achieving sustainable development in the Iraqi economic units, es
... Show MoreIn light of today's business world, who faces challenges and intense competition as a result of the rapid evolution of technical and informational, organizations had to respond to variables through the adoption of modern management techniques that reduce the effects of risks and activating the role of the internal control system in order to contribute to the early detection of risks and reduce the negative results expected .The research is to address the problem faced by organizations which still follow the traditional methods in the control activities, and the lack of knowledge of the management and their staff of the importance of the existence of risk management and internal control system takes into account these risks, and the limit
... Show More
The rubber ropes exercises affected muscle groups, which in turn affects the corners of the conditions of the body before and over the barrier where affected the time passed. To change the angle of the approaching and payment impact on passing each times the barrier 1-5. That passed over the barrier 1and gate 5 impacts on the nature of the achievement, where time has become less. Find the values of cruise missiles and other phases and stages of pitch angle other categories which it enshrines stood as compelling rejection men's 110m hurdles. Find the value of the instant messaging distances between different barriers and stages. Studies by adding rubber sling barriers race categories, measurement of kinematic variables. Emphasis on the devel
... Show More
The importance of research is to be considered by highlighting the tax policy in Iraq which extended for successive measurement of the amount of tax receipts for respective periods, the research problem represents security, economic and political issues that Iraq suffered which were very difficult since Nineties of the last century until now that led to a lake of clarity in tax policy trends, volatility in it and finally reflected on the tax revenues increase or decrease. One of the main recommendations of the research is: (The necessity to develop a deliberate strategy for tax policy in Iraq which should take into account financial, economic, and social goals in appropriate way).
Earth dams are constructed mainly from soil. A homogenous earth dam is composed of only one material. The seepage through such dams is quite high. Upstream impervious blanket is one of the methods used to control seepage through the dam foundations. Bennet's method is one of the commonly used methods to design an impervious upstream blanket. Design charts are developed relating the length of blanket, total reservoir head, total base width of the dam (excluding downstream drainage), the coefficient of permeability of the blanket material, blanket thickness, foundation thickness, and coefficient of permeability of the foundation soil, based on the equations governing the Bennet's method for a homogenous earth dam with a blanket of uniform
... Show More
The construction sector consumes large amounts of energy during the lifetime of a building. This consumption starts with manufacturing and transferring building materials to the sites and demolishing this building after a long time of occupying it. The topic of energy conservation and finding the solution inside the building spaces become an important and urgent necessity. It is known that the roof is exposed to a high amount of thermal loads compared to other elements in a building envelope, so this needs some solutions and treatments to control the flow of the heat through them. These solutions and treatments may be achieved by using nanomaterials. Recently, nanomaterials have high properties, so that this made them go
... Show More
(11)