Transarterial embolization to control posterior epistaxis

Posterior nasal epistaxis is a challenging problem for the otolaryngologist, particularly when patients are critically ill after significant blood loss. The purpose of this paper is to describe a new radiologic technique designed to enhance the treatment of acute nasal hemorrhage. Seven patients with posterior nasal epistaxis underwent portable, computerized, digital subtraction angiography before embolization. Results are presented, and the advantages and limitations of this approach are compared and contrasted with those of nasal packing and arterial ligation. We conclude that this new procedure permits rapid location of the bleeding source and safe, rapid placement of a maxillary arterial catheter for hemostasis by embolization.