[Relapsing epistaxis: embolization as treatment of choice]

Area of Science:

• Otolaryngology
• Interventional Radiology
• Vascular Surgery

Background:

• Epistaxis (nosebleeds) is common, with severe posterior cases often requiring hospitalization.
• Traditional treatments like nasal packing and arterial ligation have limitations, including potential failure and surgical complexity.
• Arterial ligation, while an alternative, faces challenges due to anatomical variations and potential anastomoses.

Purpose of the Study:

• To evaluate the efficacy and safety of therapeutic embolization for managing recurrent and severe epistaxis.
• To compare outcomes in patients with essential epistaxis versus those with underlying systemic diseases.

Main Methods:

• Fifteen patients with recurrent nasal bleeding underwent embolization using Polyvinyl Alcohol (PVA) particles.
• Patients included those with essential epistaxis and those with conditions like hereditary hemorrhagic telangiectasia and angiomas.
• Outcomes were assessed based on bleeding control following the procedure.

Main Results:

• Therapeutic embolization achieved good bleeding control in 90% of patients with essential epistaxis after one procedure.
• Satisfactory bleeding control was observed in patients with hereditary hemorrhagic telangiectasia.
• The procedure demonstrated efficacy and safety in managing complex epistaxis cases.

Conclusions:

• Therapeutic embolization with PVA particles is a highly effective treatment for recurrent persistent epistaxis.
• Its efficacy, speed, and safety profile make it a preferred option over traditional methods.
• Embolization offers a viable solution for challenging epistaxis cases unresponsive to other treatments.