Therapeutic Embolization for the Treatment of Epistaxis: A Study of 20 Cases and a Review of the literature.
Transcatheter arterial embolization (TAE) was employed to control the nasal bleeding in 20 patients. Four patients had organic diseases and the other 16 had intractable idiopathic epistaxis. The embolization was usually performed by the co-axial system using a microcatheter. The results of treatment of the four organic diseases was satisfactory. Among the 16 patients with intractable epistaxis extravasation was found in only two cases and all bleeding was stopped by TAE. One patient experienced recurrent bleeding four months following embolization and he required additional embolization. No neurological complications were noted, but one patient had severe mucositis with ulceration along the facial arterial territory caused by facial TAE using Gelfoam. Transarterial embolization of epistaxis is very safe and effective and the procedure should be considered as more aggresive therapy. However, transarterial embolization and transantral ligation have distinct advantages in different clinical situations. A good working relationship between the otolaryngologist and the interventional radiologist provides the greatest chance for success in controlling intractable epistaxis.