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Transarterial embolization to control posterior epistaxis.

J N Hicks1, G Vitek

  • 1Division of Otolaryngology/Head and Neck Surgery, University of Alabama School of Medicine, Birmingham 35233.

The Laryngoscope
|October 1, 1989
PubMed
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This study introduces a new digital subtraction angiography technique for treating severe posterior nosebleeds. It allows for quick identification and treatment of the bleeding source, improving patient outcomes.

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.

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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.