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January 1995

Therapeutic Embolization in the Treatment of Intractable Epistaxis

Arch Otolaryngol Head Neck Surg. 1995;121(1):65-69. doi:10.1001/archotol.1995.01890010051009

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)