Endovascular Treatment of Epistaxis

ABSTRACT

Epistaxis is a common problem that occurs in 60% of the population. We reviewed 119 cases with epistaxis refractory to conventional medical therapy treated between January 1987 and October 2001. They underwent selective angiographic embolization. The success rate was near 100% when bilateral internal maxillary and bilateral facial arteries were embolized. No major complications were encountered. Embolization should be considered as the treatment of choice for refractory primary epistaxis and for many cases of secondary epistaxis.

KEYWORDS

Epistaxis - embolization

REFERENCES

• 1 Small M, Murray J, Maran A. A study of patients with epistaxis requiring admission to hospital.  Health Bull (Edinb) . 1982;  40 24-29
• 2 Osborn A. The nasal arteries.  AJR Am J Roentgenol . 1978;  130 89-97
• 3 Parnes L S, Heeneman H, Vinuela F. Percutaneous embolization for control of nasal blood circulation.  Laryngoscope . 1987;  97 1312-1315
• 4 Mohammed M E, Parnes L S, Fox A J, Pelz D M, Lee D H. Therapeutic embolization in the treatment of intractable epistaxis.  Arch Otolaryngol Head Neck Surg . 1995;  121 65-69
• 5 Sudoff H, Stark T, Luckhaupt H, Knorz S, Borkowski G. Clinical note: massive epistaxis after rupture of intracavernous carotid artery aneurysm.  Ann Otol Rhinol Laryngol . 2000;  109 776-778
• 6 Kim J, Putman C, Farkas J, Varvares M. Imaging case study of the month. Paraclinoid internal carotid artery aneurysm presenting as massive epistaxis.  Ann Otol Rhinol Laryngol . 2000;  109 782-786
• 7 Williams P M, Traquina D, Wallace R, Niezgoda J. Coil embolization of a ruptured carotid pseudoaneurysm presenting as epistaxis-pediatric otolaryngology: principles and practice.  Am J Otolaryngol . 2000;  21 38-42
• 8 Schaitkin B, Strauss M, Houck J K, Hershey P A. Epistaxis: medical surgical therapy-a comparison of efficacy, complications and economic considerations.  Laryngoscope . 1987;  97 1392-1397
• 9 Wang L, Vogel D M. Posterior epistaxis: comparison of treatment.  Otolaryngol Head Neck Surg . 1981;  89 1001-1006
• 10 Metson R, Lane R. Internal maxillary artery ligation for epistaxis: an analysis of failures.  Laryngoscope . 1988;  98 760-764
• 11 Vitek J J. Idiopathic intractable epistaxis: endovascular therapy.  Radiology . 1991;  181 113-116
• 12 Sokoloff J, Wickbom I, McDonald D. Therapeutic percutaneous embolization in intractable epistaxis.  Radiology . 1974;  111 285-287
• 13 Tseng E, Narducci C A, Willing S J, Sillers M J. Angiographic embolization for epistaxis: a review of 114 cases.  Laryngoscope . 1998;  108 615-619
• 14 Strong E B, Bell D A, Johnson L P, Jacobs J M. Intractable epistaxis: transantral ligation vs.  embolization-efficacy review and cost analysis. Otolaryngol Head Neck Surg . 1995;  113 674-678
• 15 Elhai M M, Parnes L S, Fox A J, Pelz D M, Lee D H. Therapeutic embolization in the treatment of intractable epistaxis.  Arch Otolaryngol Head Neck Surg . 1995;  121 65-69
• 16 Merland J J, Melki J P, Chiras J. Place of embolization in the treatment of severe epistaxis.  Laryngoscope . 1987;  97 1312-1315
• 17 Elden L, Montanera W, Terbrugge K. Angiographic embolization for the treatment of epistaxis: a review of 108 cases.  Otolaryngol Head Neck Surg . 1994;  111 44-50