Therapeutic embolization in the treatment of intractable epistaxis

Abstract

Objective: To determine the effectiveness of therapeutic embolization in the treatment of intractable epistaxis.

Design: Cohort.

Setting: Tertiary care hospital.

Patients: Consecutive referred sample of 57 patients with intractable epistaxis.

Intervention: Percutaneous transfemoral catheterization and angiography of the internal maxillary arteries. Embolization of the most distal branches with 0.1- to 0.9- cm3 medium-sized polyvinyl alcohol particles on the suspected side of bleeding.

Outcome: Outcome was successful if no further interventional treatment was required for epistaxis.

Results: Anatomical abnormalities precluded embolization in three patients. Three of the remaining 54 patients required supplementry embolization. Including these three patients, 52 (96%) of 54 patients had successful control epistaxis. The major neurologic complication rate was 6% (three of 54 patients), with no permanent deficits.

Conclusions: Therapeutic embolization is an effective and safe technique and should be considered as the primary treatment modality in severe epistaxis.