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Related Experiment Videos

[Selective embolisation of posttraumatic intractable epistaxis].

Jens Nickel1, Wolfgang Sachs, Reimer Andresen

  • 1Abteilung für Diagnostische Bildgebung und Interventionelle Radiologie, Güstrower Krankenhaus, Akademisches Lehrkrankenhaus, Universität Rostock. jnickel@krankenhaus-guestrow.de

Rontgenpraxis; Zeitschrift Fur Radiologische Technik
|November 19, 2003
PubMed
Summary

Severe nosebleeds unresponsive to standard treatment can be effectively managed with endovascular embolization. This minimally invasive procedure targets the sphenopalatine artery, offering a low-complication solution for intractable epistaxis.

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Area of Science:

  • Otolaryngology
  • Interventional Radiology
  • Trauma Surgery

Background:

  • Intractable epistaxis (nosebleeds) poses a significant clinical challenge, often requiring advanced interventions when conservative measures fail.
  • Surgical vascular ligature and endovascular occlusion are established therapeutic options for severe cases.

Observation:

  • A patient presented with severe epistaxis following splanchnocranial injuries from a bicycle accident.
  • Computed tomography (CT) revealed fractures of the posterior nasal septum and inferior nasal concha.
  • Despite nasal packing, the patient developed anemia necessitating blood transfusion.

Findings:

  • Transcatheter embolization was performed via a transfemoral approach, accessing the maxillary artery.
  • Supraselective catheterization of the sphenopalatine artery branches was achieved using a tracker system.

Related Experiment Videos

  • Digital subtraction angiography (DSA) identified the sphenopalatine artery as the source of bleeding.
  • Embolization with mini-coils successfully occluded the bleeding vessel, achieving hemostasis within minutes.

    • Implications:

    • Supraselective embolization of the sphenopalatine artery is a highly effective and minimally invasive treatment for severe posttraumatic epistaxis.
    • This technique offers a low-complication alternative for managing intractable nosebleeds, even in emergency settings.
    • Interdisciplinary collaboration is crucial for optimal patient management in complex epistaxis cases.