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Published on: September 20, 2020
Trans-radial embolization of epistaxis in patients with end-stage liver disease
Satoshi Tateshima1, Michael Froehler, Ryan Cramer
1Division of Interventional Neuroradiology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, CA 90095-7437, USA. stateshima@mednet.ucla.edu
Introduction:
Endovascular treatment of epistaxis in patients with bleeding disorders is challenging due to the intrinsic risk of hemorrhagic complication related to the arterial access. We describe the use of trans-radial approach for the endovascular embolization of epistaxis due to end-stage liver disease and resultant severe coagulopathy.
Methods:
Two patients waiting for liver transplant continued to have epistaxis despite the aggressive correction of the coagulopathy and nose packing. After performing the Allen's test, trans-radial embolization of the epistaxis was performed in both patients.
Results:
The complete cessation of epistaxis was achieved after the trans-radial embolization of bilateral maxillary arteries with particles. The radial access sites were manually compressed for 1 h, followed by a compression dressing for 12 h. The cessation of the epistaxis helped the subsequent treatment of correcting the coagulopathy. There was no complication related to the arterial puncture.
Conclusion:
Trans-radial embolization for epistaxis was a safe and effective method for the patient with end-stage liver disease and resultant severe coagulopathy.
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