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Article
Primary Percutaneous Coronary Intervention in Acute ST Elevation Myocardial Infarction: A Single Centre Experience

Authors: Ahmed Hussein AL- Mayali --- Mushtaq T. Al-Hassnawi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2018 Volume: 11 Issue: 2 Pages: 3978-3987
Publisher: Kerbala University جامعة كربلاء

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Abstract

background Early revascularization is critically important in the management of patients presenting with acute myocardial infarction.Aim To assess the benefit of early primary percutaneous coronary intervention in patients with acute ST elevation myocardial infarction.Methods This study include 51 patients with acute STEMI they were selected from those who were admitted to the coronary care unit of Karbala cardiac center in Karbala-Iraq during a period between January 2017 and February 2018. Detailed history and thorough physical examination was done. Investigations done for each patient in form of ECG, cardiac troponin, blood urea, serum creatinine, and complete blood picture.Results & discussion percutaneous coronary intervention only, using one stent, two stent, three stent, aspiration catheter, CABG & medical treatment, 7 (13.7%),25(49%), 8(15.6%), none , 4(7.8%), 4(7.8%), 4(7.8%), 3(5.8%) respectively).Infarct related artery, LAD, LCX, RCA & LMS (30(58.8%), 4(7.8%), 6(11.7%), 2(3,9%) respectively, and the number of diseased vessels , single vessel, two vessels, three vessels & LMS which was (20(39.2%), 13(25.4%), 14(27.4%) respectively.Inhospital outcome, which include the following:- favorable outcome, period of hospitalization, access site bleeding, contrast induced nephropathy, death, respectively. Which were (96%, ˂ 1day 38(74.5%), ˃1day 13(25.5), 3.9%, 5.8%, 3.9% respectively)Conclusion in case of ST elevation myocardial infarction, left anterior descending artery is most culprit vessel to be involved, one quarter of patient needs one stent & carry favorable out comes in form of less complications and also decrease the period of hospitalization.

Keywords

primary PCI --- acute MI


Article
Effect of Learning Curve in Transradial Approach to Coronary Angiography and Percutaneous Intervention
تأثير منحنى التعلم عبر الشريان الكعبري لقسطرة الشرايين التاجية والتداخل القسطاري

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Background: TR approach is suitable for most patient and limitations is very low. It become more popular and approved in international guidelines because of increase success rate and low complication rate and low cost. There is also parallel advancement in instruments used in TR approach.Objective: To establish the rule of learning curve in transradial approach to CA and PCI and encourage the operator for doing more transradial catheterization.Patients and Methods: Patients admitted for CA or PCI. Data collected from patient and procedure including age, sex, contrast volume, total procedure time. flouro time, radial artery spasm and number of cases that transformed to femoral. We divided the study in two groups: group A first half of patient and group B the second half.Results: Total numbers of patients (139) and there age ranging from 28 to 80 years (mean of 55.13). Number of males 131 (94.2%) and females 8 (5.7%).The mean value of contrast volume used in group A that underwent CA, ad hoc and PCI ,(was 63.10,124.20 and 106.91 ml) respectively and for group B (50.07,88.19 and 49.56 ml).The mean total time of procedure of group A underwent CA, ad hoc and PCI was (17.16,24.9 and 26.13 minutes) respectively and for group B(13.66,26.3 and 16.4 minutes).The mean fluorotime of group A underwent CA, ad hoc and PCI was (4.61,7.2 and 6.62 minutes) and for group B (3.06,7.32 and 3.51 minutes ). Seventeen case subjected to radial artery spasms divided into 11 cases (15.7%) in group A and 6 cases (8.69 %) in group B. There were 8 cases (11.4 %) of group A transferred to femoral approach and 4 cases (5.79 %) of group B transferred to femoral access.Conclusion: There was much benefit from the effect of learning curve in doing TR approach to CA and PCI.

خلفية الدراسة: نهج القسطرة عبر الشريان الكعبري مناسب لمعظم المرضى والقيود منخفضة للغاية. أصبح أكثر شعبية والموافقة عليها في المبادئ التوجيهية الدولية بسبب زيادة معدل النجاح وانخفاض معدل المضاعفات وانخفاض التكلفة. هناك أيضا تقدم مواز في الأدوات المستخدمة في نهج القسطرة عبر الشريان الكعبري .اهداف الدراسة: لوضع قاعدة منحنى التعلم في النهج عبر الحدود ل CA و PCI وتشجيع المشغل لفعل المزيد من القسطرة عبر الحدود.المرضى والطرائق: المرضى الذين تم قبولهم في القسطرة التشخيصية أوالتداخل القسطاري . البيانات التي تم جمعها من المريض والإجراء بما في ذلك العمر والجنس وكمية الصبغة المستخدمة ، وقت الإجراء الكلي و وقت الاشعاع ، تشنج الشريان الكعبري وعدد الحالات التي تحولت إلى شريان الفخذ. قمنا بتقسيم الدراسة إلى مجموعتين: المجموعة الأولى أ للنصف الأول والمجموعة ب للنصف الثاني.النتائج: إجمالي عدد المرضى (139) وهناك عمر يتراوح من 28 إلى 80 عامًا (متوسط 55.13). عدد الذكور 131 (94.2 ٪) والإناث 8 (5.7 ٪). القيمة المتوسطة لكمية الصبغة المستخدمة في المجموعة (أ) التي خضعت القسطرة التشخيصية ، التداخل القسطاري المحتمل وتداخل قسطاري ، (كان 63.10 ، 124.20 و 106.91 مل) على التوالي وللمجموعة ب ( 50.07،88.19 و 49.56 مل). متوسط الوقت الإجمالي لإجراء المجموعة (أ) خضعت قسطرة تشخيصية ، التداخل القسطاري المحتمل وتداخل قسطاري كان ( 24.9,17.16 و 26.13 دقيقة) على التوالي وللمجموعة ب ( 13.66 ,26.3 و 16.4 دقيقة). معدل وقت الاشعاع من المجموعة (أ) خضعت قسطرة تشخيصية ، التداخل القسطاري المحتمل وتداخل قسطاري كان ( 7.2,4.61 و 6.62 دقيقة) وللمجموعة ب (3.06,7.32 و 3.51 دقيقة). سبعة عشر حالة خضعت لتشنجات الشريان الكعبري مقسمة إلى 11 حالة (15.7٪) في المجموعة أ و 6 حالات (8.69٪) في المجموعة ب. كانت هناك 8 حالات (11.4٪) من المجموعة "أ" تم نقلها إلى القسطرة عن طريق الفخذ و 4 حالات (5.79٪) ) من المجموعة ب نقلها إلى القسطرة عن طريق الفخذ.الاستنتاجات: كان هناك فائدة كبيرة من تأثير منحنى التعلم في القيام بنهج القسطرة عبر الشريان الكعبري للقسطرة التشخيصية والتداخل القسطاري.


Article
Lineament automatic extraction analysis for Galal Badra river basin using Landsat 8 satellite image
تحليل التراكيب الخطية المستخرجة أوتوماتيكيا لمساحة حوض نهر كلال بدرة باستخدام الصور الفضائية لاندسات 8

Authors: Safaa Sabah Adhab صفاء صباح --- Mustafa Ali Hassan مصطفى علي حسن
Journal: Iraqi Journal of Physics المجلة العراقية للفيزياء ISSN: 20704003 Year: 2014 Volume: 12 Issue: 25 Pages: 44-55
Publisher: Baghdad University جامعة بغداد

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Abstract

This research including lineament automated extraction by using PCI Geomatica program, depending on satellite image and lineament analysis by using GIS program. Analysis included density analysis, length density analysis and intersection density analysis. When calculate the slope map for the study area, found the relationship between the slope and lineament density. The lineament density increases in the regions that have high values for the slope, show that lineament play an important role in the classification process as it isolates the class for the other were observed in Iranian territory, clearly, also show that one of the lineament hit shoulders of Galal Badra dam and the surrounding areas dam. So should take into consideration the lineaments because its plays an important role in the study area.

تضمن هذا البحث استخراج التراكيب الخطية اتوماتيكيا باستخدام برنامج PCI Geomatica وبالاعتماد على الصور الفضائية الحديثة و تحليل التراكيب الخطية باستخدام برنامج نظم المعلومات الجغرافية. وشمل التحليل تحليل كثافة التراكيب الخطية، وتحليل كثافة الاطوال وتحليل كثافة التقاطع. عند احتساب خريطة الانحدار لمنطقة الدراسة، وجدت علاقة مابين الانحدار وكثافة التراكيب الخطية. وجد بان كثافة التراكيب الخطية تزداد في المناطق ذات الانحدار العالي. تبين أن التراكيب الخطية تلعب دورا هاما في عملية التصنيف لأنه يعزل فئة لأخرى لوحظت في الأراضي الإيرانية، بشكل واضح، كما لوحظ بان احد التراكيب الخطية يضرب الكتف الايمن لسد كلال بدرة والمناطق المحيطة بالسد. لذا يجب اخذ التراكيب الخطية بنظر الاعتبار لما تلعبه من دور هام في منطقة الدراسة.


Article
Percutanous revascularization of chronic total occlusion of diabetic patients at Iraqi center for heart diseases, a single center experience 2012

Author: Hassan Abdul Amir Al-Daghir
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2015 Volume: 2 Issue: 2 Pages: 76-82
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

We aimed to evaluate the influence of DM on the results of PCI of patents with CTO and to compare that with the results in non-diabetic patients. Prospectively studied 150 consecutive cases of CTO with PCI at Iraqi center for heart diseases- Baghdad/Iraq for the period January– December 2012. Success of revascularization of chronic total occlusion by percutaneous coronary intervention was similar in both sexes (male 69.4%, female 72.4%). Intervention was successful in (40) out of (55) patients with diabetes mellitus (72.7%) which was identical to those without diabetes mellitus (66 patients out of 95 patients 69.47%). The success in diabetic and non- diabetic groups in the absence of other risk factors was (64.2%) and (62%) while in the presence of these risk factors it was (73.1%) and (71.2 %) respectively. In (11) out of the (15) patients with diabetes failed intervention was attributed to inability to pass the wire (73.3 %) compared to (23) out of the (29) non-diabetic patients (79.3%). While failure to pass the balloon was identical in both groups (13.3%) compared (13.7) and failure to pass a stent while it was not reported compared to (3.4%) in both diabetic and non-diabetic patients respectively. As far as failure of procedure, passing the wire into a false lumen occurred in one patient (6.6%) of diabetic group, while creation of perforation had occurred in one patient (6.6%) in diabetics. Successful revascularization has led to a prompt relieve of symptoms; angina and improved exercise tolerance as well as enhanced left ventricular function equally in both groups. Regarding CTO- PCI, there was no much difference between success in diabetic and non-diabetic.

Keywords

DM --- PCI --- CTO --- HTN --- HLP


Article
Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in Ibn Alnafees Hospital, Baghdad

Authors: Majid Abdul Muhsin Falih --- Alaa AbdulHussein Allawi --- Raed Sabri Al Abboodi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 3 Pages: 310-312
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUD:Primary percutaneous coronary intervention (PCI) provides outcomes superior to fibrinolytic therapy in acute myocardial infarction (AMI), but no registry or study in Iraq has demonstrated its use in hospital.OBJECTIVE: To evaluate using of primary PCI for acute MI in Ibn Alnafees hospital –Baghdad.METHODS: Patients between 2010 and march 2013 having symptom onset within 12 hours and either ST-segment elevation of - 1 mm in - 2 contiguous leads or presumed new left bundle branch block (LBBB) in electrocardiogram (ECG) who were treated with primary PCI were included in this study. Two patient had cardiogenic shock treated within 16 hours.RESULTS:A total of 76 patient included in this study having primary PCI for acute MI. successful result reported in 71 of cases, while death reported in 2 cases, slow flow in 2 cases, no re flow in one case and stent thrombus formation in one case. No need for urgent or elective CABG.CONCLUSION: Primary PCI for patients with AMI having ST-elevation or new LBBB is a safe and effective strategy


Article
The Role Of Emergency PCI In The Management Of Acute STEMI The Local Experience In Al-Nassiriya Heart Center

Authors: Ali Khalid Almaliki --- Ali Jabbar Alibrahemi --- Tahsin Ali Al-kinani
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 2 Pages: 1-7
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Primary PCI is an emergent percutaneous catheter intervention in the setting of STEMI,without previous fibrinolytic treatment .It is the prefered strategy in patients with STEMI.Aim: To evaluate the immediate and intermediate procedural and clinical outcome in a local experience.Methods: This is a descriptive cross sectional study carried out in a tertiary cardiac center for 301 patirnts with acute myocardial infarction. Fifty patients(16.6%) were followed up prospectively for one month up to one year in the outpatient clinic.Results: primary PCI was done in 294 patients (97.6%) and rescue PCI was done in 7 patients (2.4%). Ischemic time is ranging from one hour to twenty four hours (mean 5.02±3.27) . Procedural success rate was 100%. Mortality rate was 5.3% mostly because of cardiogenic shock. Conclusion: Primary PCI should be the standered of care for patients with STEMI.

Keywords

Primary PCI --- immediate --- long term --- outcome


Article
In hospital outcome and complications of percutaneous coronary intervention in acute coronary syndrome, Gender Differences

Authors: Najah AL-Mosawi --- Amaal N. AL-Marayati
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2008 Volume: 50 Issue: 4 Pages: 420-423
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: women with acute coronary syndrome have increased in-hospital morbidity & mortality as compared with men following percutaneous coronary intervention (PCI). It remains unclear if this difference secondary to the sex or other confounding variables.
Patients and Methods: We sought to examine the characteristics and outcomes of 71 consecutive women (49.2%) and men (50.7) undergoing PCI at The Iraqi Center of Heart Diseases from October 2005 to March 2006.
Results: There were significant differences in the baseline characteristics between both sexes. Women more frequently had SVD(single vessel desiease) (25.7% vs. 16.6%) and 2VD (37.1% vs. 16.6%) while Men were more frequently had 3VD(3 vessel disease) (66.6% vs. 31.4%) P value = 0.05. Women more frequently had LAD lesions (97.1% vs. 83.3%; P=0.05). Men had longer lesion length (13.60±7.75 vs. 12.42±5.12; P=0.03. The outcome of revascularization procedure reveal that the female cohort had a greater incidence of thrombosis (17.1% vs. 2.8% ; P=0.049) and myocardial ischemia (34.2% vs. 13.9%; P=0.044) during procedure and greater incidence of access site hematoma (31.4% vs. 2.7%; P=0.001), hypotension (25.7% vs. 5.6%; P=0.02), non-fatal MI (17.1% vs. 2.7%; P=0.044) and needed more repeated angiography and revascularization (17.1% vs. 5.5%; P=0.0049) during post procedural in-hospital period.
Conclusion: female gender is at greater risk for per procedural and post procedural in-hospital complication, these were not due to female sex itself, but because female have more co morbid diseases and risk factors with smaller body size and smaller blood vessels causing more risky PCI.


Article
Success rate of Percutaneous Coronary Intervention of Chronic Total Occlusion

Author: Ghazi F. Haji
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 1 Pages: 75-82
Publisher: Baghdad University جامعة بغداد

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Abstract

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 lesion length 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.Keywords: Chronic total occlusion (CTO) – percutaneous coronary intervention (PCI) – coronary arteries


Article
Definition of Pavement Distresses of Road No. (80) in Hilla City by Paver (PCI) Method and its Repair Methods
تحديد عيوب تبليط شارع 80)) بمدينة الحلة بطريقة بيفر (PCI) وطرق اصلاحها

Author: jasim atea alwan جاسم عطية علوان
Journal: KUFA JOURNAL OF ENGINEERING مجلة الكوفة الهندسية ISSN: 25230018 Year: 2013 Volume: 4 Issue: 2 Pages: 1-18
Publisher: University of Kufa جامعة الكوفة

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Abstract

The aim of this research is a site study for flexible surface pavement distresses in ring road no. (80) in Hilla city which is two directions road of (9.85) km length, (8.0) m pavement width, (2.5) m shoulders and (5) m median width. The road consist of asphaltic concrete layer (10) cm thickness, sub base of (20) cm thickness and embankment about (1.0) m. The road pavement distresses that appeared despite its short age which is about five years raised inquiries. The road was divided to (98) stations with (100) m length for each direction. The site inspection was excuted and writing the road distresses according to Paver method then finding Pavement Condition Index (PCI) values for each sector. The (PCI) values of pavement showed that (120) sections are in fair conditions, (76) sections are poor and the pavement include (9) distresses from a (19) standard distresses due to bad site execution and design of roads layers, bad quality of asphaltic wearing course to resist traffic loads and to repair these distresses we need to spray emulsion asphalt layer, remove places of wearing course and to remove all road layers and to rebuilt in another locations

يهدف البحث الى اجراء دراسة ميدانية لعيوب التبليط المرن السطحية للطريق رقم 80)) الدائري في مدينة الحلة وطوله (9.80) كم ذو اتجاهين وعرض التبليط 8)) متر وعرض الاكتاف 2.5)) متر وجزرة وسطية بعرض (5) متر. يتكون الطريق من طبقة اسفلت خرسانية بسمك (10) سم وطبقة حصو خابط بسمك ((20 سم وتعلية ترابية حوالي (1) متر. ظهرت في تبليط الطريق بعض العيوب رغم عمره القصير البالغ حوالي خمس سنوات أثارت التساؤل. تم تقسيم الطريق الى (98) محطة بطول ((100 متر لكل اتجاه. اجري الكشف الموقعي وتم تدوين عيوب التبليط وحسب طريقة بيفر وأيجاد قيم معامل حالة التبليط (PCI) لكل قطاع. أوضحت نتائج ال(PC I) للتبليط ان (120) قطاع كانت بحالة متوسطة وان 76)) قطاع ضعيفة وان في التبليط 9)) عيوب من (19) عيب قياسي لسوء تنفيذ وتصميم طبقات الطريق ورداءة الطبقة الاسفلتية السطحية لمقاومة أحمال المرور ولأصلاح العيوب نحتاج الى رش طبقة اسفلت رغوي , ازالة اجزاء من الطبقة السطحية والى ازالة كل طبقات الطريق واعادة عملها بمواقع اخرى.


Article
Complication Following percutaneous coronary intervention via the femoral artery Experience in lraqi center for the Heart Disease and lbn Al-Bitar Hospital for cardiac surgery.
المضاعفات الوعائية للشريان الفخدي من جراء القسطرة التشخيصية و العلاجية في المركز العراقي لامراض القلب و مستشفى ابن البيطار لجراحة القلب

Authors: Amal N. AL- Marayati --- Hilal Bahjet Al Saffar --- Salah M. Majeed
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2016 Volume: 58 Issue: 4 Pages: 325-329
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Vascular complications have been recognized as an important factor in morbidity after diagnostic and percutaneous coronary interventions.Objectives: This study sought to evaluate vascular complications after diagnostic coronary angiography and percutaneous coronary intervention (PCI) from the common femoral artery.Patients and methods: This prospective cohort study was carried out over a year period, from February 2008 till January 2009, at the Iraqi Center for the Heart Disease and Ibn Al-Bitar Hospital for Cardiac Surgery. A total number of 2400 patients underwent 3600 procedures, diagnostic coronary angiography (2196) and PCI(1404) via their common femoral arteries were included in this study.Result: A total 407(11.3%) patients developed different vascular complications (retroperitoneal hematoma, loss of distal pulse, arterial perforation each of them 0.03%, bruises 8.9%, pseudoaneurysm 0.69%, AV fistula 0.03%, hematoma ≥10cm 0.3% and <10cm 1.2%). We identified multiple factors associated with increased frequency of vascular complications like age, gender and past medical history. We have more frequent minor complications and more attendance to treat our complications surgically.Conclusions: This study has shown that the vascular complications continue to occur post PCI and diagnostic coronary angiography.

الخلفية: تهدف هذه الدراسة الى تقييم المضاعفات الوعائية التي تحدث بعد القسطرة التشخيصية و التداخل القسطاري من خلال الشريان الفخدي , لانه لوحظ ان المضاعفات الوعائية عامل مهم في المراضه بعد القسطرة التشخيصية و التداخل القسطاريطريقة البحث: تم اجراء هذه الدراسة في مركزين تخصصين لامراض القلب هما المركز العراقي لامراض القلب و مستشفى ابن البيطار لجراحة القلب امتدت الدراسة للفترة من شباط 2008 الى كانون الثاني 2009.النتائج: ضمت الدراسة عينة من 2400 مريض اجروا 3600 تداخل قسطاري منها 1404 تداخل علاجي و 2196 تداخل تشخيصي و لوحظ حصول مضاعفات لدى 407 مريض أي نسبة 11.3% . والمضاعفات التي تمت ملاحظتها قسمت الى مجموعتين (حسب تقسيم الكلية القلبية الامريكية) هي مضاعفات كبرى مثل ودمة خلف البريتون 0.03%, فقدان نبض الشريان الدواسة 0.03% , اختراق الشريان 0.03% , و مضاعفات صغرى مثل ودمة ≤10 سم 0.03%, ودمة > 10 سم 1.2%, تمدد الاوعية الدموي المزيف 0.69 %, ناسور شرياني وريدي 0.03%, ووجدنا عدة عوامل تودي الى زيادة المضاعفات الوعائية .ايضا وجدنا ان المضاعفات الكبرى لدينا اقل قليلا من الدراسات السابقة لكن الصغرى اكثر و حاجتنا للجراحة لعلاج هذه المضاعفات اكثر.الاستنتاج: المضاعفات الوعائية بعد اجراءالقسطرة التشخيصية و العلاجية ما زالت تحدث بالرغم من التطور الحاصل في هذا االمجال. مفاتيح الكلمات : المضاعفات الوعائية, الشريان الفخدي, التداخل القسطاري العلاجي

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