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Interventional Radiology Procedure Preserves Uterus in Patients with Placenta Accreta

Placement of balloons in the internal iliac arteries prior to a Caesarean section after placenta accreta protects against hemorrhage and is safe for both mother and baby. A multidisciplinary team plans both an elective Caesarean section and prophylactic balloon placement under fluoroscopic guidance. Following delivery the balloons are inflated to slow blood flow to the uterus, allowing the obstetrician time to gain control of the hemorrhage. Over a 44-month period, the hospital treated 21 patients who underwent balloon placement immediately followed by C-section. Balloons were inflated in 13 of the 21 deliveries. The interventional procedure was a technical success in 100 percent of the cases, with no maternal or fetal complications resulting from the procedure.

Common Knee Surgery May Lead to Arthritis and Cartilage Loss

Evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint. Researchers studied data from patients in the Osteoarthritis Initiative, including MR imaging (MRI) exams of 355 knees that developed osteoarthritis during a five-year period and a control group. Of all knees, 31 underwent meniscal surgery during the year prior to the arthritis diagnosis and 280 had signs of meniscal damage on MRI but did not have surgery. All 31 of the knees that underwent surgery developed osteoarthritis, compared with 59 percent of the knees with meniscal damage that didn't have surgery. Nearly 81 percent of knees with surgery showed cartilage loss, compared with 40 percent of knees with meniscal damage and no surgery.

Many Chest X-rays in Children Are Unnecessary

Researchers reviewed data from 719 pediatric chest X-ray exams ordered between 2008 and 2014 in inpatient, outpatient and emergency room settings. Patients undergoing the exams ranged in age from newborn to 17 years old. Of the 719 exams, 377 were ordered for chest pain, 98 indicated syncope or presyncope, 21 indicated spells, 37 indicated postural orthostatic hypotension (POTS), 185 indicated dizziness, and one exam indicated cyclical vomiting. Eighty-two of the 719 exams were excluded due to congenital or other known heart disease and other causes. Researchers found that in approximately 88 percent of the remaining 637 patients, the exam did not alter clinical treatment.

More information is available online at RSNA.org/Press14.

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