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.
The reconciliation of tax reconciliation is one of the legal methods used by the financial authority in Iraq, which is done with the taxpayer
The research dealt with the weakness of tax revenues for many reasons, including tax evasion, which led to the search for ways to reduce evasion to increase the tax revenue, and settlement reconciliation one of these means .
The research proceeded from the premise that the use of a more broadly settled settlement would govern the tax evasion of taxpayers.
The researchers used a series of studies and previous research, books and other sources related to the subject of research, and this was done through the theoretical framework, and the practical aspect that included the fin
... Show MoreThe current research aims to identify (the effect of CORT program on creative thinking for middle school students in the art education history of ancient art subject).
The research society continue of the5th of scientific students in ALsadreen secondary school of excellence which related of the Directorate of Education al-sader city, for the academic year (2015/2016), The sample was (35) students for each of the two groups (experimental and control). The equivalence between the research groups was carried out in the IQ variable, the age and the level of the father and mother.
The researcher used the experimental method of partial control and the post-test. If the course of
... Show MoreThe issue of the research lies in the non-representation of the models developed for the communication process in the interaction and networking processes through social media, as the research sought to build a network model of communication according to the specific data and features of social media platforms in order to reach a special generalization to understand how the process of networking operates in cyberspace.
The researcher followed the analytical survey approach as she described the communication models outwardly in order to be able to build a networked communication model that represents the flow of post-reactive communication. Therefore, it has been named "Nebula - Sadeem" after the concept of post-space and cosmic g
... Show MoreThe research has tackled about an important transformation within the whole region of middle east, especially there were more challenges which revealed under the huge pivotal interests of global powers that ruled the new world order by United states of America ; being very affected over the international and regional relations than any situations appeared previously within political realities. So that, many of variables inside the international scene which happened during of this period of contradicting strategic policies by the process of reforming and restructuring of difficult equations that imposed by international and regional allies and blocs . This article had concentrated over various strategic and political studies which reflect
... Show MoreWhen optimizing the performance of neural network-based chatbots, determining the optimizer is one of the most important aspects. Optimizers primarily control the adjustment of model parameters such as weight and bias to minimize a loss function during training. Adaptive optimizers such as ADAM have become a standard choice and are widely used for their invariant parameter updates' magnitudes concerning gradient scale variations, but often pose generalization problems. Alternatively, Stochastic Gradient Descent (SGD) with Momentum and the extension of ADAM, the ADAMW, offers several advantages. This study aims to compare and examine the effects of these optimizers on the chatbot CST dataset. The effectiveness of each optimizer is evaluat
... Show MoreWith the recent growth of global populations, main roads in cities have witnessed an evident increase in the number of vehicles. This has led to unprecedented challenges for authorities in managing the traffic of ambulance vehicles to provide medical services in emergency cases. Despite the high technologies associated with medical tracks and advanced traffic management systems, there is still a current delay in ambulances’ attendance in times of emergency to provide patients with vital aid. Therefore, it is indispensable to introduce a new emergency service system that enables the ambulance to reach the patient in the least congested and shortest paths. However, designing an effici
This paper presents an analytical study for the magnetohydrodynamic (MHD) flow of a generalized Burgers’ fluid in an annular pipe. Closed from solutions for velocity is obtained by using finite Hankel transform and discrete Laplace transform of the sequential fractional derivatives. Finally, the figures are plotted to show the effects of different parameters on the velocity profile.
Islamic banks are a financial institution that is interested in attracting financial savings from financial entities and directing them towards those with financial deficits, both for consumption purposes or for investment purposes. It provides banking services provided by commercial banks and other services But based on the principles and principles of Islamic law, and because of its recent emergence in Iraq, its ability to attract savings is not like non-Islamic commercial banks, which puts them in the option of using their capital to achieve its objective of banking. The research started from the premise that "Islamic banks in Iraq during the period (2008-2012) rely on their capital to perform their activities more than they rely on d
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