Therapeutic Embolization in the Treatment of Intractable Epistaxis

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Abstract
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-cm3medium-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)

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