Intractable epistaxis: transantral ligation vs. embolization: efficacy review and cost analysis

Area of Science:

• Otolaryngology
• Interventional Radiology
• Vascular Surgery

Background:

• Intractable epistaxis (nosebleeds) often requires intervention beyond posterior nasal packing.
• Transantral ligation of the internal maxillary artery and percutaneous embolization are common, yet controversial, treatment options.
• Optimal management strategies for severe posterior epistaxis require further comparative analysis.

Purpose of the Study:

• To retrospectively compare the efficacy, safety, and cost of transantral ligation versus percutaneous embolization for intractable epistaxis.
• To review current literature and highlight the indications and advantages of each treatment modality.

Main Methods:

• Retrospective chart review of 21 patients treated for intractable epistaxis.
• Data collected included patient presentation, risk factors, treatment details, success rates, complications, and costs.
• Comparison between transantral ligation and percutaneous embolization groups.

Main Results:

• Success rates were high for both procedures: 89% for transantral ligation and 94% for percutaneous embolization.
• No mortality or serious morbidity was observed with either technique.
• Transantral ligation was moderately less expensive ($5941) than percutaneous embolization ($6783).

Conclusions:

• Transantral ligation and percutaneous embolization are comparable in efficacy and safety for intractable epistaxis.
• Each procedure has distinct strengths and weaknesses influencing treatment selection.
• Individual patient needs should guide the choice between transantral ligation and percutaneous embolization.