Percutaneous embolization to control epistaxis in Rendu-Osler-Weber disease

Recurrent epistaxis is the most common manifestation of hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease), a disorder characterized by widely scattered visceral, dermal, and mucosal vascular lesions. Emergency measures applied locally may control acute hemorrhage, but seldom result in long-term benefit. Recently, we have had the opportunity of performing bilateral carotid angiographic examination on a patient with hereditary hemorrhagic telangiectasia who was suffereing from severe intractable epistaxis. At the time of angiographic examination, embolization of both internal maxillary arteries was accomplished, and control of the epistaxis was achieved. In the patient with severe epistaxis that is unresponsive to local measures, percutaneous embolization offers substantial advantages over surgical intervention.