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.
<p>Energy and memory limitations are considerable constraints of sensor nodes in wireless sensor networks (WSNs). The limited energy supplied to network nodes causes WSNs to face crucial functional limitations. Therefore, the problem of limited energy resource on sensor nodes can only be addressed by using them efficiently. In this research work, an energy-balancing routing scheme for in-network data aggregation is presented. This scheme is referred to as Energy-aware and load-Balancing Routing scheme for Data Aggregation (hereinafter referred to as EBR-DA). The EBRDA aims to provide an energy efficient multiple-hop routing to the destination on the basis of the quality of the links between the source and destination. In
... Show MoreCyber-attacks keep growing. Because of that, we need stronger ways to protect pictures. This paper talks about DGEN, a Dynamic Generative Encryption Network. It mixes Generative Adversarial Networks with a key system that can change with context. The method may potentially mean it can adjust itself when new threats appear, instead of a fixed lock like AES. It tries to block brute‑force, statistical tricks, or quantum attacks. The design adds randomness, uses learning, and makes keys that depend on each image. That should give very good security, some flexibility, and keep compute cost low. Tests still ran on several public image sets. Results show DGEN beats AES, chaos tricks, and other GAN ideas. Entropy reached 7.99 bits per pix
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... Show MoreConstruction contractors usually undertake multiple construction projects simultaneously. Such a situation involves sharing different types of resources, including monetary, equipment, and manpower, which may become a major challenge in many cases. In this study, the financial aspects of working on multiple projects at a time are addressed and investigated. The study considers dealing with financial shortages by proposing a multi-project scheduling optimization model for profit maximization, while minimizing the total project duration. Optimization genetic algorithm and finance-based scheduling are used to produce feasible schedules that balance the finance of activities at any time w
Electronic Health Record (EHR) systems are used as an efficient and effective method of exchanging patients’ health information with doctors and other key stakeholders in the health sector to obtain improved patient treatment decisions and diagnoses. As a result, questions regarding the security of sensitive user data are highlighted. To encourage people to move their sensitive health records to cloud networks, a secure authentication and access control mechanism that protects users’ data should be established. Furthermore, authentication and access control schemes are essential in the protection of health data, as numerous responsibilities exist to ensure security and privacy in a network. So, the main goal of our s
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