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Published on: June 18, 2021
[Clinical research on delayed traumatic epistaxis and pseudoaneurysm]
Guang-Gang Shi1, Shou-Guo Yao, Zhao-Di Wang
1Department of Otorhinolaryngology, Shandong Provincial Hospital Shandong University, Jinan 250021, China. 7036285@163.com
Summary
Delayed traumatic epistaxis can stem from carotid artery pseudoaneurysms or fistulas, and maxillofacial artery pseudoaneurysms. Digital subtraction angiography and embolization or ligation are key for diagnosis and treatment.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Trauma Medicine
Background:
- Delayed traumatic epistaxis presents diagnostic and therapeutic challenges.
- Identifying the precise vascular source is crucial for effective management.
Purpose of the Study:
- To investigate the diagnosis and treatment strategies for delayed traumatic epistaxis.
- To propose the concept of arteriola pseudoaneurysmal epistaxis originating from maxillofacial arteries.
Main Methods:
- Retrospective analysis of 53 patients with delayed traumatic epistaxis.
- Digital subtraction angiography (DSA) for diagnosis.
- Transcatheter arterial embolization (TAE) and surgical ligation for treatment.
Main Results:
- Identified interval carotid artery pseudoaneurysm (8 patients), carotid cavernous fistula (20 patients), and maxillofacial artery hemorrhage (25 patients).
- TAE and endovascular occlusion showed high success rates.
- One case of recurrent hemorrhage was successfully treated with artery ligation.
Conclusions:
- Interval carotid artery pseudoaneurysm, carotid cavernous fistula, and maxillofacial arteriola pseudoaneurysm are primary causes of delayed traumatic epistaxis.
- Early DSA and timely intervention with TAE or ligation are effective treatment modalities.
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