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Therapeutic embolization in the treatment of intractable epistaxis
M M Elahi1, L S Parnes, A J Fox
1Department of Otolaryngology, University of Western Ontario, London.
Objective:
To determine the effectiveness of therapeutic embolization in the treatment of intractable epistaxis.
Design:
Cohort.
Setting:
Tertiary care hospital.
Patients:
Consecutive referred sample of 57 patients with intractable epistaxis.
Intervention:
Percutaneous transfemoral catheterization and angiography of the internal maxillary arteries. Embolization of the most distal branches with 0.1- to 0.9- cm3 medium-sized polyvinyl alcohol particles on the suspected side of bleeding.
Outcome:
Outcome was successful if no further interventional treatment was required for epistaxis.
Results:
Anatomical abnormalities precluded embolization in three patients. Three of the remaining 54 patients required supplementry embolization. Including these three patients, 52 (96%) of 54 patients had successful control epistaxis. The major neurologic complication rate was 6% (three of 54 patients), with no permanent deficits.
Conclusions:
Therapeutic embolization is an effective and safe technique and should be considered as the primary treatment modality in severe epistaxis.