Transcatheter Embolization in the Management of Epistaxis

Gregory J. Dubel; Sun Ho Ahn; Gregory M. Soares

doi:10.1055/s-0033-1353478

Seminars in Interventional Radiology, Table of Contents

Semin intervent Radiol 2013; 30(03): 249-262
DOI: 10.1055/s-0033-1353478

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transcatheter Embolization in the Management of Epistaxis

Gregory J. Dubel

¹Department of Diagnostic Imaging, Division of Interventional Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island

,

Sun Ho Ahn

¹Department of Diagnostic Imaging, Division of Interventional Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island

,

Gregory M. Soares

¹Department of Diagnostic Imaging, Division of Interventional Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island

› Author Affiliations

Abstract

A majority of the population will experience epistaxis at some time in their life. Most cases will be from an anterior source and can be treated with pressure, anterior nasal packing, or cautery. Intractable epistaxis is generally posterior in origin and may require endoscopic cautery, posterior packing, surgical ligation, or embolization. Embolization has been used to treat epistaxis for more than 30 years and success can be achieved in approximately 90% of patients, with major complications occurring in approximately 2%. These excellent results require thorough knowledge of the regional anatomy, familiarity with the equipment and various agents used to achieve this type of embolization, as well as attention to detail and meticulous technique. There remains debate on several aspects of embolization, including the agent of choice, preferred size of the embolic, and the number of vessels to embolize. Advances in endoscopic surgery have evolved to the point that similar success rates for embolization and modern surgical techniques in treating epistaxis may be expected. This detailed review of pertinent vascular anatomy, embolization technique, and surgical alternatives should allow practitioners to formulate treatment algorithms that result in optimal outcomes at their institutions.

Keywords

epistaxis - embolization - complications - review - internal maxillary artery - interventional radiology

Full Text

References

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