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[Percutaneous embolization therapy in severe cervicofacial hemorrhages]
B Kramann1, L Defreyne, G Schneider
1Abteilung für Radiodiagnostik, Radiologische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar.
Purpose:
To analyse the use of transcatheter embolisation.
Material And Methods:
We report on 43 patients treated by transcatheter embolisation for head and neck haemorrhage from 1987 to 1995. There were 13 patients with idiopathic intractable epistaxis, 6 with iatrogenic and three with traumatic bleeding, 7 patients with bleeding from vascular malformations, 12 patients with haemorrhage from tumours, one ruptured aneurysm of the inferior thyroid artery and one patient bleeding from a retrolingual dystrophic goitre.
Results:
In 11/13 patients with idiopathic epistaxis, this could be stopped. In 8/9 of the traumatic and iatrogenic bleedings the haemorrhage was treated by embolisation alone. In two cases additional elective surgical interventions were necessary. In 6/7 patients with vascular malformations embolisation resulted in long-lasting periods free from bleeding. Palliative embolisation in bleeding tumours resulted in haemostasis in 10/12 patients. Bleeding was definitely stopped in a patient with aneurysm of the inferior thyroidal artery as well as in a patient with bleeding from a dystrophic goitre. We observed a total of three complications, two transitory neurological disturbances and one permanent amaurosis.
Conclusion:
Transcatheter embolisation is an effective tool in the treatment of life-threatening head and neck bleedings.