Transarterial embolization to control posterior epistaxis

Area of Science:

• Radiology
• Otolaryngology
• Interventional Radiology

Background:

• Posterior epistaxis presents significant challenges, especially in critically ill patients with substantial blood loss.
• Current treatments like nasal packing and arterial ligation have limitations in managing severe posterior nasal hemorrhage.

Purpose of the Study:

• To describe a novel radiologic technique for enhancing the treatment of acute posterior nasal hemorrhage.
• To evaluate the efficacy and safety of digital subtraction angiography followed by embolization for epistaxis.

Main Methods:

• Seven patients with posterior epistaxis underwent portable, computerized, digital subtraction angiography.
• Embolization was performed after identifying the bleeding source via angiography.
• The technique was compared to traditional methods like nasal packing and arterial ligation.

Main Results:

• Digital subtraction angiography enabled rapid and precise localization of the bleeding source in all patients.
• Safe and efficient placement of a maxillary arterial catheter for embolization was achieved.
• The technique demonstrated advantages over conventional treatments in speed and accuracy.

Conclusions:

• The described radiologic technique offers a rapid and effective method for managing severe posterior epistaxis.
• Digital subtraction angiography followed by embolization provides a safe approach for achieving hemostasis.
• This innovative procedure enhances the otolaryngologist's ability to treat challenging nasal hemorrhage cases.