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.
ABSTRACT
The simulation of groundwater movement has been carried out by using MODFLOW model
in order to show the impact of change of water surface elevation of the Tigris river on layers of
the aquifer system for Nuclear Research Center at Al-Tuwaitha area, in addition to evaluate the
ability of the proposed pumping well to collect groundwater and change the direction of flow at
steady-state. The results of the study indicated that there is a good match between the values of
groundwater levels that calculated in the model and measured in the field, where mean error is
0.09 m.
The study also showed that the increasing of water surface elevation of the
The present study deals with the story of Epidemic in two literary works issued in the same year (1947). One of them is a novel titled "Plague" written by the French writer Alber Kamo, the second is a poem of the Iraqi poetess Nazik Al-Malaekah. The research reflects a contrastive study of the war vision in the two works as both writers used science to serve literature by using Epidemic as a metaphor to refer to the dangers that the societies faced.
The problem of the present research lies in answering the question about the reason that makes the two writers use metaphor while narrating the issues of the society instead of mentioning them directly and illuminate what implications do the narrative style of Epidemic story have and
... Show MoreWadi AL – yabis situated to the north jorden , its extended from Aglon
mountain to the jorden river , the surveying of this valley about 186 KM , and the
highest point in it about 1200 m upon the sea level , the lower point ther under the
sea level . This study lay to appear the historical important and to study the variation
of environment and population which happened in the different periods , in the
beginning the Paleolithic until the later period , and to understand the environment ,
political and economical circumstances , which it can to influenced or limited in
human behavior from choosing , the settlement sits and than ( we could ) knowledge
of living ways and the tools which they used in there living a
The research Aim is to provide support to small enterprises by providing tools that enable measurement and test their performance and identifying weaknesses and work on them is determined by the problem of searching using traditional assessment methods for small projects with only financial performance measurement standards that do not provide a complete picture of the performance of these projects so use the balanced scorecard the four pillars (financial, customer, learning and growth, and internal processes) and identify deviations and work on them through the use of the outputs of the programme (probe), PROmoting Business Excellence-PROBE), which It is a model of performance evaluation, with which you can deve
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Government expenditure represents one of the controlling financial policies in the economic affairs and management of the economic cycle in order to achieve price stability, raise the rate of output growth and decrease the level of unemployment. The price stability represents one of the macroeconomic goals that all countries seek without exception, regardless of the economic philosophy adopted by each country; in addition to this is raising the productive capacity and reaching the actual output to the level of the expected output, that is, the level of output related to the natural unemployment rate or what is sometimes called the Non-inflationary unemployment rate. The restriction of government expenditure (G=T+∆B/iP+∆M/P) is
... Show MoreThe removal of turbidity from produced water by chemical coagulation/flocculation method using locally available coagulants was investigated. Aluminum sulfate (alum) is selected as a primary coagulant, while calcium hydroxide (lime) is used as a coagulant aid. The performance of these coagulants was studied through jar test by comparing turbidity removal at different coagulant/ coagulants aid ratio, coagulant dose, water pH, and sedimentation time. In addition, an attempt has been made to examine the relationship between turbidity (NTU) and total suspended solids (mg/L) on the same samples of produced water. The best conditions for turbidity removal can be obtained at 75% alum+25% lime coagulant at coagulant dose of 80 m
... Show MoreThe objective of this work is to study the influence of end milling cutting process parameters, tool material and geometry on multi-response outputs for 4032 Al-alloy. This can be done by proposing an approach that combines Taguchi method with grey relational analysis. Three cutting parameters have been selected (spindle speed, feed rate and cut depth) with three levels for each parameter. Three tools with different materials and geometry have been also used to design the experimental tests and runs based on matrix L9. The end milling process with several output characteristics is solved using a grey relational analysis. The results of analysis of variance (ANOVA) showed that the major influencing parameters on multi-objective response w
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Two different oxidative desulfurization strategies based on oxidation/adsorption or oxidation/extraction were evaluated for the desulfurization of AL-Ahdab (AHD) sour crude oil (3.9wt% sulfur content). In the oxidation process, a homogenous oxidizing agent comprising of hydrogen peroxide and formic acid was used. Activated carbons were used as sorbent/catalyst in the oxidation/adsorption process while acetonitrile was used as an extraction solvent in the oxidation/extraction process. For the oxidation/adsorption scheme, the experimental results indicated that the oxidation desulfurization efficiency was enhanced on using activated carbon as catalyst/sorbent. The effects of the operating conditions (contact time, temperat
... Show MoreIt was Aristotle who first drew attention to the superior quality of literature to the other factual fields of knowledge. Contradicting his predecessor Plato on the issue of „truth,‟ Aristotle believed that „poetry is more philosophical and deserves more serious attention than history: for while poetry concerns itself with universal truths, history considers only particular facts.‟ (1) The critical attention to the disparity between the literary truth and the historical truth grew up throughout ages to flourish in the Renaissance and after with a bunch of distinctive views on this subject. Sir Philip Sidney (1554-1586), for example, found that literature does not offer a literal description of reality but rather a heightened vers
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