Publications by authors named "Kohi M"

Purpose: The aim of this study was to determine changes in procedural utilization for symptomatic uterine fibroids and adenomyosis from 2011 to 2020.

Methods: An institutional review board-exempt retrospective study of the National Inpatient Sample database from 2011 to 2020 was performed using International Classification of Diseases, Ninth Revision, and International Classification of Diseases, 10th Revision, diagnosis and procedural codes for uterine fibroids, adenomyosis, hysterectomy, myomectomy, uterine artery embolization (UAE), and endometrial ablation. Patients with endometriosis, uterine cancer, placenta accreta spectrum, pelvic inflammatory disease, and uterine prolapse were excluded.

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Purpose: To determine the extent of impact that social determinants of health have on uterine artery embolization (UAE) utilization for treatment of symptomatic uterine fibroids.

Materials And Methods: In this institutional review board (IRB)-exempt study, data from the 2011-2020 National Inpatient Sample were used to identify patients with International Classification of Diseases, 9th and 10th editions, codes of uterine fibroids who underwent UAE. Data collected included patient demographics (race/ethnicity, income, and insurance status) and procedure location (geographic region and hospital setting).

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Marburg viral disease (MVD) is a highly infectious disease with a case fatality rate of up to 90%, particularly impacting resource-limited countries where implementing Infection Prevention and Control (IPC) measures is challenging. This paper shares the experience of how Tanzania has improved its capacity to prevent and control highly infectious diseases, and how this capacity was utilized during the outbreak of the MVD disease that occurred for the first time in the country in 2023.In 2016 and the subsequent years, Tanzania conducted self and external assessments that revealed limited IPC capacity in responding to highly infectious diseases.

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Reproductive outcomes after uterine artery embolization (UAE) for the treatment of uterine fibroids are challenging to study, leaving several unanswered questions surrounding the future fertility of patients undergoing the procedure. Subject matter experts from interventional radiology, diagnostic radiology, obstetrics and gynecology, and reproductive medicine participated in a Society of Interventional Radiology (SIR) Foundation Research Consensus Panel to discuss and prioritize critical research topics focusing on fertility and reproductive outcomes in patients undergoing UAE for symptomatic uterine fibroids. After presentations and discussion of research ideas, the panelists prioritized the following topics for further investigation: (a) a prospective study of factors that influence implantation and gene expression in patients undergoing UAE or myomectomy over 1 year; (b) refinement of a classification system for uterine fibroids that can allow for more focused study design, which may include burden of fibroid disease; and (c) conjoint analysis/discrete choice experiments to better characterize those patients for whom fertility preservation is a high priority.

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Background: The extent and consequences of ischemia in patients with chronic limb-threatening ischemia (CLTI) may change rapidly, and delays from diagnosis to revascularization may worsen outcomes. We sought to describe the association between time from diagnosis to endovascular lower extremity revascularization (diagnosis-to-limb revascularization [D2L] time) and clinical outcomes in outpatients with CLTI.

Methods And Results: In the CLIPPER cohort, comprising patients between 66 and 86 years old diagnosed with CLTI betweeen 2010 and 2019, we used Medicare claims data to identify patients who underwent outpatient endovascular revascularization within 180 days of diagnosis.

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Interventional radiology shows promises in the field of women's health, particularly in pelvic interventions. This review article discusses the latest advancements in interventional radiology techniques for pelvic conditions affecting women including adenomyosis, abdominal wall endometriosis and uterine leiomyoma. Extraperitoneal endometriosis involving the abdominal wall may be treated by percutaneous thermal ablation, such as cryoablation, whereas uterine leiomyoma and adenomyosis can be managed either using percutaneous thermal ablation or using uterine artery embolization.

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Objective: Women and underrepresented minorities (URMs) who are at an increased risk of presenting with severe peripheral artery disease (PAD) and have different responses to treatment compared with non-Hispanic White males yet are underrepresented in PAD research.

Methods: ELEGANCE is a global, prospective, multi-center, post-market registry of PAD patients treated with drug-eluting device that aims to enroll at least 40% women and 40% URMs. The study design incorporates strategies to increase enrollment of women and URMs.

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Article Synopsis
  • - Infertility impacts around 15% of people globally, with proximal fallopian tube obstruction (FTO) accounting for a significant portion, specifically 25% of tubal disease cases.
  • - Tubal patency can be assessed using various methods, and fallopian tube recanalization (FTR) has a high success rate, potentially leading to pregnancy in 12.8% to 51% of cases, especially when using oil-based contrast media.
  • - Although FTR is effective, it is often underused in treating infertility caused by proximal FTO, and it may offer a less expensive alternative to more invasive procedures like in vitro fertilization, also reducing emotional and physical burdens on patients.
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Article Synopsis
  • This study aimed to find variables that predict long-lasting success after treating uterine fibroids using MRI-guided focused ultrasound (MRgFUS).
  • In a trial with 99 women, researchers measured changes in symptom severity over 36 months and developed the NPV/TFL ratio to assess its impact on treatment outcomes.
  • Results showed that a higher ratio of non-perfused volume to total fibroid load and lower fibroid volume were linked to significant symptom improvement, with the NPV/TFL ratio being the strongest predictor of long-term clinical success.
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Article Synopsis
  • The study analyzed the use of medical devices and outcomes related to lower extremity peripheral arterial interventions for different racial groups using data from the American College of Cardiology National Cardiovascular Data Registry from 2014 to 2019.
  • It found that while Black patients had higher rates of specific health conditions and socio-economic challenges, they received drug-eluting technologies more often than White patients, but there were no significant differences in the use of atherectomy or intravascular imaging.
  • Interestingly, Black patients were less likely to undergo surgical or repeat procedures after 1 year, although there were no differences in mortality or major amputations between the groups.
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Interventional radiology has had an expanding role in women's health over the past few decades, with recent accelerated growth and development. Interventional radiology is fundamental in the treatment of multiple conditions that affect women, including pelvic venous disease, uterine fibroids, and adenomyosis, and in postpartum management. Patient workup, classification, and treatment techniques have continued to evolve as interventional radiology has become more prevalent in the treatment of patients affected by these conditions.

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Purpose: To determine whether fallopian tube embolization with n-butyl-2-cyanoacrylate (nBCA) administered via a microcatheter in a rabbit model was technically feasible and resulted in short-term tubal occlusion.

Materials And Methods: In 10 female New Zealand white rabbits, the 2 cervices were cannulated using a 5-F catheter and hydrophilic guide wire transvaginally. Salpingography confirmed tubal patency bilaterally.

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Purpose: To evaluate temporal trends, practice variation, and associated outcomes with the use of intravascular ultrasound (US) during deep venous stent placement among Medicare beneficiaries.

Materials And Methods: All lower extremity deep venous stent placement procedures performed between January 1, 2017, and December 31, 2019 among Medicare beneficiaries were included. Temporal trends in intravascular US use were stratified by procedural setting and physician specialty.

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Background: There has been growing use of intravascular ultrasound (IVUS) during lower extremity arterial and venous revascularization. Observational data suggest that the use of IVUS can improve periprocedural and long-term outcomes, but largescale prospective data remain limited. Consensus opinion regarding the appropriate use of IVUS during peripheral intervention is needed.

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The recent iohexol shortage has precipitated disruptions in a pharmaceutical supply chain critical to radiologic imaging and has impacted global availability of iodinated contrast media (ICM). The shortage has created a national crisis in radiology departments, curtailing their ability to provide health care to patients who need contrast-enhanced examinations. Radiology departments are familiar with crisis management after more than 2 years of clinical and operational disruptions associated with the COVID-19 pandemic.

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Adenomyosis poses an important diagnostic and therapeutic challenge in women's health because of a variety of clinical/imaging presentations and frequent coexistence with other benign gynecologic conditions. In recent years, uterine artery embolization (UAE) for the treatment of adenomyosis has shown encouraging and favorable outcomes and long-term symptom improvement. To expand the current understanding of adenomyosis pathophysiology, imaging diagnostic criteria, and treatment outcomes, the Society of Interventional Radiology Foundation gathered a multidisciplinary Research Consensus Panel with experts from diverse backgrounds.

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This review details the utility of intravascular ultrasound (IVUS) for the management of peripheral artery and venous disease. The purpose of this document is to provide an update in the use of IVUS in peripheral arterial and venous pathology and demonstrate the use of IVUS as a practical diagnostic imaging procedure to evaluate and treat peripheral vascular disorders. IVUS, a diagnostic tool that relies on sound waves to produce precise images of the vessel being evaluated, was originally introduced to the medical community for the purposes of peripheral artery imaging, though it was quickly adapted for coronary interventions with positive outcomes.

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Purpose: To compare the cost-effectiveness of tunneled peritoneal catheter (TPC) versus serial large-volume paracenteses (LVP) for patients with recurrent ascites.

Materials And Methods: Retrospective, single-institution analysis of 100 consecutive patients undergoing LVP and eventual TPC placement (2015-2018) was performed with extraction of procedural complications and hospital admissions. LVPs were associated with 17 adverse events (AEs) while only 9 AEs occurred after TPC placement.

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Roughly 37% of Americans 60 years of age and older experience chronic pain due to osteoarthritis (OA) of the knee. After conservative treatment (pharmacologic, physical therapy, and joint injections) fails, patients often require total knee arthroplasty to alleviate pain and regain knee function. Given the high economic burden of surgery paired with its invasive nature, many patients with this degenerative joint disease seek alternative treatment.

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