Embolization for the Treatment of Posterior Epistaxis: An Analysis of 31 Cases

Siniluoto, T; Leinonen, A; Karttunen, Ari; Karjalainen, H; Jokinen, K.

doi:10.1001/archotol.1993.01880200037005

Cited by 68 publications

(42 citation statements)

References 11 publications

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“…Complications of embolizations can be divided into major and minor. The major complications include cerebral vascular accidents, blindness, ophthalmoplegia, facial nerve palsy, and necrosis of soft tissues 6 . Minor complications are transient and include facial pain, headaches, mental confusion, paresthesia, jaw pain, groin pain, numbness, and facial edema.…”

Section: Resultsmentioning

confidence: 99%

“…Sokoloff et al 2 in 1974 described two patients with refractory epistaxis who were successfully treated with angiography and selective embolization of the ipsilateral IMA. Subsequently, several authors studied the efficacy of this approach as a treatment option for severe refractory epistaxis 3‐8 . The importance of preembolization arteriography was quickly recognized 9 .…”

Section: Introductionmentioning

confidence: 99%

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Angiographic Embolization for Epistaxis: A Review of 114 Cases

et al. 1998

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Angiography with selective embolization has become an accepted method of treating posterior epistaxis that is not controlled with conservative measures. The authors reviewed 112 cases of patients who had received selective angiographic embolization for refractory epistaxis from January 1990 to December 1995. There were 114 embolizations over this 5-year period. The immediate success rate was 93%, with long-term success achieved in 88% of patients. The overall complication rate was 17%, with the long-term morbidity rate less than 1%. Selective angiographic embolization is a safe and effective method that should be considered in the treatment of refractory epistaxis.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Angiographic Embolization for Epistaxis: A Review of 114 Cases

et al. 1998

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“…The superiority of one surgical treatment versus another surgical treatment has yet to be demonstrated in either an observational study or a randomized clinical trial. Reported failure rates for arterial ligation ( 1, 2 ), endoscopic cautery ( 3‐5 ), and angiographic embolization ( 6‐9 ) each range from approximately 10 to 25%. The reported complication rates for arterial ligation and embolization are also very similar ( 1, 6, 7 ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Surgical Management of Epistaxis at a Tertiary Care Center

1997

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A retrospective review is presented of 44 consecutive patients requiring hospitalization for epistaxis at a tertiary care center. The study had the following objectives: 1. to identify predictors of surgical treatment, and 2. to compare the effectiveness of different surgical treatments. Length of stay, complications, and cost analysis are also presented. Eighteen patients were successfully treated nonsurgically, whereas 26 patients received surgical treatment. Posterior epistaxis (P<0.05) and an admission hematocrit less than 38% (P<0.05) were significant predictors of surgical treatment. The rebleed rate after first surgical therapy was 33% for embolization, 33% for endoscopic cautery, and 20% for ligation. Since embolization, ligation, and endoscopic cautery may have nearly equivalent failure rates, other factors, such as cost and institutional expertise, should guide the selection of surgical treatment.

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“…79 Unfortunately, the indications for embolization are not well defined, and there are severe neurologic complications associated with this procedure in up to 50% of patients. 9 Reported complications include accidental embolization of the brain with hemiplegia, facial pain, facial paresthesias, ophthalmoplegia, blindness secondary to embolization of the ophthalmic artery, bilateral facial paralysis secondary to distal occlusion and ischemia of the geniculate ganglion and horizontal segment of the facial nerve, and necrosis of the skin and soft tissues of the face. 7 " 9 · 12…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ligation of the Internal Maxillary Artery for Treatment of Intractable Posterior Epistaxis

Pritikin¹,

Caldarelli²,

Panje³

1998

Ann Otol Rhinol Laryngol

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Lack of universal success with both transantral ligation of the internal maxillary artery and percutaneous embolization of the distal branches of the internal maxillary distribution has led to consideration of alternative techniques to control intractable posterior epistaxis. One such technique takes advantage of advances in endoscopic technology and instrumentation, as well as a nearly constant anatomic configuration. The internal maxillary artery divides into terminal branches within the pterygomaxillary fossa, sending branches through the bony maxilla to exit the posterolateral nasal wall in the posterior aspect of the middle meatus. Endoscopic identification and ligation of these terminal branches of the internal maxillary artery (the sphenopalatine and nasopalatine arteries) as they exit the maxilla has been performed on 10 patients with a 100% success rate and no morbidity or mortality associated with the procedure. These results compare favorably to the average reported success rates of 89% for transantral ligation and 94% for percutaneous embolization, and average complication rates of 28% and 27%, respectively. This endonasal procedure has been performed for spontaneous epistaxis as well as postsurgical nasal bleeding with equal success. The ascending scale of treatment previously outlined in the literature may be amended, as a potentially definitive procedure is available, and we believe that this technique is easier to perform, has less associated morbidity, and has equal efficacy in comparison to transantral ligation or percutaneous embolization in the treatment of intractable posterior epistaxis.

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Embolization for the Treatment of Posterior Epistaxis: An Analysis of 31 Cases

Cited by 68 publications

References 11 publications

Angiographic Embolization for Epistaxis: A Review of 114 Cases

Angiographic Embolization for Epistaxis: A Review of 114 Cases

Effectiveness of Surgical Management of Epistaxis at a Tertiary Care Center

Endoscopic Ligation of the Internal Maxillary Artery for Treatment of Intractable Posterior Epistaxis

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