Selective embolization in the treatment of intractable epistaxis

Abstract

In Group A, 15 procedures were performed, 12 of which were beneficial as the duration and number of episodes of epistaxis were reduced. In Group B, 15 procedures were performed and the success rate was 87%. One patient suffered from skin necrosis at the tip of the nose. No other serious side-effects of the treatment were observed.

Hereditary hemorrhagic teleangiectasia: the topical problems of diagnostics and surgical treatment

“…Для терапии острых носовых кровотече ний наиболее часто используется тампонирование полости носа, однако удаление тампонов может при вести к повторному кровотечению. Можно миними зировать возможное повреждение слизистой атрав матическим тампонированием, используя лубри канты или пневматическое тампонирование [67,68].…”

Interventional Neuroradiology of the Head and Neck

“…39,41 The most common cause of the failure of this technique is bleeding from the anterior ethmoidal artery. 39,42 Recurrent bleeding is not uncommon in patients with HHT; however, embolization often decreases the severity of hemorrhage and improves the quality of life in these patients. 40 Complications resulting from the treatment are usually minor, including groin hematoma, facial numbness, mucosal necrosis, and sinusitis.…”

“…This technique is safe and effective and is associated with very few complications. 39,40 At our institution, we prefer to use general anesthesia for the embolization procedures and use conscious sedation only if the patient is a high risk for general anesthesia. Selective angiography of bilateral ICAs and ECAs is first performed with 4F or 5F catheters.…”

“…Although transantral ligation of the internal maxillary arteries can be performed, a failure rate of up to 24% has been described with this technique. 39 Endovascular embolization for epistaxis is an attractive therapeutic option for the patients with intractable epistaxis. This technique is safe and effective and is associated with very few complications.…”

“…38 Only 6% of patients require medical or surgical attention, and intractable epistaxis is relatively uncommon. 39 Causes of epistaxis include hereditary hemorrhagic telangiectasia (HHT), craniofacial trauma, infections, tumors, bleeding disorders, vascular abnormalities, and anticoagulation therapy. 39,40 In some patients, no definite cause can be identified, and it is labeled as idiopathic.…”