Arterial Embolization as a Treatment to Severe Epistaxis: A Case Report
Introduction: Epistaxis is a common condition and, fortunately, most cases resolve spontaneously. Only 6% of epistaxis cases require medical intervention. When initial measures, such as anterior and posterior packing of the nasal cavity, are unsuccessful in controlling the bleeding, interruption of the blood supply to the nasal cavity can be performed by transarterial embolization.
Objectives: This study aims to report a case of embolization as treatment to epistaxis.
Resumed Report: A 56-year-old man, hypertensive, with hepatitis C virus and chronic renal failure undergoing hemodialysis, presented to the emergency room with severe posterior bleeding at the right nasal cavity. Anterior and posterior packing were performed, but the patient remained with intermittent epistaxis and worsening of his clinical condition. Because of the patient´s comorbidities and the great risk of life-threatening bleeding during surgical artery ligation, he underwent embolization of the right internal maxillary artery. The procedure was successful and completely stopped the bleeding.
Conclusion: Embolization can be an optional treatment for severe posterior epistaxis. The ability to stop bleeding with embolization therapy immediately following the procedure has been reported to be between 93 and 100%. However, transarterial embolization requires an experienced interventional radiologist and qualified equipment, and it also has been associated with serious complications including hemiplegia and facial paralysis.