Embolization for the treatment of posterior epistaxis. An analysis of 31 cases
T. M. Siniluoto, A. S. Leinonen, A. I. Karttunen, H. K. Karjalainen and K. E. Jokinen
Department of Diagnostic Radiology, University Central Hospital of Oulu, University of Oulu, Finland.
Thirty-one patients with posterior epistaxis refractory to nasal packing
alone or in combination with surgical ligation (n = 8) underwent diagnostic
angiography and therapeutic embolization of the internal maxillary artery.
Embolization resulted in the cure of epistaxis in 22 cases (71.0%). Of the
nine failures (29.0%), seven underwent successful surgical clipping of the
ethmoid arteries, and two were treated conservatively and died of their
primary hematologic disease within 33 days. Late rebleeding occurred in two
patients: one underwent re-embolization and the other was treated
surgically. No severe or permanent complications occurred. The results
indicate that embolization is a feasible alternative to surgical
intervention for patients with posterior epistaxis, and we recommend it as
the treatment of choice in cases with high surgical risk or failure of
prior arterial ligation.
