Therapeutic Embolization in the Treatment of Intractable Epistaxis
Mohammed M. Elahi, MD;
Lorne S. Parnes, MD;
Allan J. Fox, MD;
David M. Pelz, MD;
Donald H. Lee, MD
Arch Otolaryngol Head Neck Surg. 1995;121(1):65-69.
Abstract
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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.
(Arch Otolaryngol Head Neck Surg. 1995;121:65-69)
Author Affiliations
From the Department of Otolaryngology (Drs Elahi and Parnes) and the Division of Neuroradiology, Department of Diagnostic Radiology (Drs Fox, Pelz, and Lee), University of Western Ontario, London.
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