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.
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In globalization, the world became open area to competition for the attractive of investment, and the abilities of each country to win the confidence of investors depend upon the preparation to optimize circumstances. The competitiveness is an essential means of expanding the capacity of developed to coexist in an international environment characterized by globalization. While competition describes the market structure, the behavior of investors and business, competitiveness is interested in the evaluation of business performance or countries and compare them in the conditions of competition available in these markets. Regarding Malaysia, which is depend on FDI-Export- Led Growth strategy, it has taking on diffe
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Abstract
This research aims to know the effect of job burnout in the worker’s performance. The researcher presented a theoretical basis for job burnout and the worker's performance. In order to achieve the objectives of the research, a hypothesis was drawn up that determines the nature of the relationship between the independent variable of job burnout and its dimensions (reduced personal accomplishment, depersonalization, Emotional Exhaustion) and variable dependent performance of workers dimensions (productivity, job satisfaction, organizational commitment, creativity), And to represent the volume of this community according to (de Morgan, D. Morgan) glo
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The relationship between costs of environment and costs of product life – cycle. Boubtlessly when the economical unit exercise their productive works, they lead to pollution in water, air and soil as well as all stages of product life- cycle from Rans Dstage, production stage, packaging stage and finally abandonment stage- Pollution causes environmental costs. Lgnoring or hiding environmental costs and no taking them in consideration with product cost lead to a wrong account of preduot cost.
Therefore, environmental costs should be included and matched for all stages with in product costs to know which activities, processes
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Chilled ceilings systems offer potential for overall capital savings. The main aim of the present research is to investigate the thermal performance of the indirect contact closed circuit cooling tower, ICCCCT used with chilled ceiling, to gain a deeper knowledge in this important field of engineering which has been traditionally used in various industrial & HVAC systems. To achieve this study, experimental work were implemented for the ICCCCT use with chilled ceiling. In this study the thermal performances of closed wet cooling tower use with chilled ceiling is experimentally and theoretically investigated. Different experimental tests were conducted by varying the controlling parameters to investigate their effects
... Show MoreMany isolated rural communities are located in regions where there is an abundant and reliable supply of solar energy, but where the distance to the nearest power station is many tens or even hundreds of kilometre. It is therefore mainly in these areas that rural electrification is now being provided by PV generators. since Stand-Alone PV generator can offer the most cost-effective and reliable option for providing power needed in remote places. Accordingly these isolated rural canters are fitted with PV for lighting, a refrigerator, a television and socket to supply kitchen appliances
A fixed firefighting system is a key component of fire safeguarding and reducing fire danger. It is installed as a permanent component in a structure to protect the entire or a portion of the building and its contents. The study aims to review the previous studies that deal with the evaluation of fire safety measures and their use in resolving problems associated with fire threats in buildings. For this reason, a number of previous studies in this field were reviewed compared with the NFPA code. The findings revealed that regulatory developments over the last several decades had created an atmosphere conducive to innovation. This has resulted in a growth in the number of fixed firefighting system types now obtainable. Th
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Detecting protein complexes in protein-protein interaction (PPI) networks is a challenging problem in computational biology. To uncover a PPI network into a complex structure, different meta-heuristic algorithms have been proposed in the literature. Unfortunately, many of such methods, including evolutionary algorithms (EAs), are based solely on the topological information of the network rather than on biological information. Despite the effectiveness of EAs over heuristic methods, more inherent biological properties of proteins are rarely investigated and exploited in these approaches. In this paper, we proposed an EA with a new mutation operator for complex detection problems. The proposed mutation operator is formulate
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