[Percutaneous therapeutic embolization in therapy refractory, non-traumatic epistaxis]

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Otolaryngology

Background:

• Severe intractable non-traumatic epistaxis poses significant clinical challenges.
• Traditional treatments may have limitations in achieving permanent hemostasis.

Purpose of the Study:

• To evaluate the efficacy of percutaneous embolization therapy for severe intractable non-traumatic epistaxis.
• To assess outcomes in patients with idiopathic epistaxis, Osler-Rendu-Weber disease, and high-flow angiomas.

Main Methods:

• Retrospective review of 24 patients with severe epistaxis.
• Percutaneous embolization of the maxillary artery and its branches was performed.
• Analysis included patients with idiopathic epistaxis, Osler-Rendu-Weber disease, and high-flow angiomas.

Main Results:

• Permanent hemostasis was achieved in 16/17 patients with idiopathic epistaxis using embolization alone.
• Repeat embolization was necessary in 5 cases of idiopathic epistaxis.
• Five of 6 patients with Osler-Rendu-Weber disease (stage III) were successfully treated with repeated embolizations, reducing them to stage I.
• A high-flow angioma was successfully ablated with embolization, thrombosing material, and laser resection.

Conclusions:

• Percutaneous embolization of the maxillary artery is a highly effective treatment for severe intractable non-traumatic epistaxis.
• Embolization therapy offers a successful management strategy for various etiologies of severe epistaxis, including Osler-Rendu-Weber disease and high-flow angiomas.
• This minimally invasive approach can lead to durable hemostasis and improved disease staging.