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Endovascular embolization of intractable epistaxis.
1Department of Radiology, Taipei Veterans General Hospital, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|April 4, 2000
Summary
Endovascular embolization effectively stops intractable epistaxis, offering a safe and efficient treatment. This procedure is recommended as a primary therapy for severe nosebleeds.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Otolaryngology
Background:
- Intractable epistaxis poses significant clinical challenges.
- Angiography and endovascular embolization are potential treatment options.
Purpose of the Study:
- To define the role of angiography and endovascular embolization in managing intractable epistaxis.
- To evaluate the efficacy and safety of endovascular embolization for severe nosebleeds.
Main Methods:
- Retrospective review of 19 patients with massive intractable epistaxis treated with endovascular embolization.
- Utilized polyvinyl alcohol (PVA) particles, gelfoam, detachable balloons with N-butyl-2-cyanoacrylate (NBCA), and coils as embolic agents.
- Predisposing factors included head and neck tumors, idiopathic causes, surgical complications, arteriovenous malformations, thrombocytopenia, and trauma.
Main Results:
- Complete cessation of epistaxis achieved in all 19 patients immediately post-embolization.
- No significant complications or recurrence observed in 18 patients; one patient with advanced cancer died due to epistaxis.
- Mean follow-up was 41 months, ranging from 15 days to eight years.
Conclusions:
- Therapeutic endovascular embolization is an efficient and safe treatment for intractable epistaxis.
- Endovascular embolization should be considered the primary treatment modality for severe, persistent nosebleeds.