Epistaxis

Koh, Elsie; Frazzini, Vincent I.; Kagetsu, Nolan J.

doi:10.2214/ajr.174.3.1740845

Cited by 66 publications

(15 citation statements)

References 6 publications

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“…Stroke and blindness are two of the most severe complications. When retinal opacification from branches of the external carotid artery (ECA) is identified, embolisation must not be performed, and the patient should be referred for surgical treatment [12–15]. …”

Section: Endovascular Therapy Of Epistaxismentioning

confidence: 99%

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Radiological Diagnosis and Management of Epistaxis

Krajina

Chrobok

2013

Cardiovasc Intervent Radiol

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The majority of episodes of spontaneous posterior epistaxis treated with embolisation are idiopathic in nature. The angiographic findings are typically normal. Specific angiographic signs are rare and may include the following: a tumour blush, telangiectasia, aneurysm, and/or extravasation. Selective internal carotid artery (ICA) angiography may show rare causes of epistaxis, such as traumatic or mycotic aneurysms, which require different treatment approaches. Complete bilateral selective external and internal carotid angiograms are essential to evaluation. The images should be analysed for detection of central retinal blush in the external carotid artery (ECA) and anastomoses between the branches of the ECA and ICA. Monocular blindness and stroke are two of the most severe complications. Embolisation aims to decrease flow to the bleeding nasal mucosa while avoiding necrosis of the nasal skin and palate mucosa. Embolisation is routinely performed with a microcatheter positioned in the internal maxillary artery distal to the origin of the meningeal arteries. A guiding catheter should be placed in the proximal portion of the ECA to avoid vasospasm. Embolisation with microparticles is halted when the peripheral branches of the sphenopalatine artery are occluded. The use of coils is not recommended because recurrent epistaxis may occur due to proximal embolization; moreover, the option of repeat distal embolisation is lost. The success rate of embolisation therapy (accounting for late recurrence of bleeding) varies between 71 and 94 %. Results from endoscopic surgery are quite comparable. When epistaxis is refractory to nasal packing or endoscopic surgery, embolisation is the treatment of choice in some centres.

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Section: Endovascular Therapy Of Epistaxismentioning

confidence: 99%

“…Specific angiographic signs are rare and may include the following: tumour blush, telangiectasia, traumatic pseudoaneurysm, and even contrast extravasation. Selective ICA angiography may show other sources of epistaxis, such as mycotic or traumatic aneurysm [12, 13]. …”

Section: Endovascular Therapy Of Epistaxismentioning

confidence: 99%

Radiological Diagnosis and Management of Epistaxis

Krajina

Chrobok

2013

Cardiovasc Intervent Radiol

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“…The floor of the nose, the palate, is vascularized by the major palatine artery (MPA), branching off the distal maxillary artery. KP = Kiesselbach plexus [6,7]. One of the most challenging aspects of epistaxis embolization is the stable positioning of the microcatheter at the bleeding site.…”

Section: Endovascular Embolization Of Posterior Epistaxismentioning

confidence: 99%

36 Endovascular Treatment of Epistaxis

2020

Video Atlas of Neuroendovascular Procedures

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Epistaxis or nosebleed is relatively common in the general population. Depending on the location of the bleeding in the nasal cavity, epistaxis can be divided in two types: anterior or posterior type. The anterior type is far more frequent, often self-limiting and, if needed, is relatively easy treatable. Posterior type epistaxis is rare and more likely to require medical attention. The cornerstone of the conservative therapy of posterior epistaxis is nasal packing. Only in patients with persistent or recurrent epistaxis, endovascular intervention or surgery is indicated. Both treatment options have a similar success and complication rate, but endovascular treatment, if feasible, has several advantages above surgical treatment. The choice of procedure should be made on a patient-to-patient basis, taking several parameters into account. In this pictorial essay we present an overview of the relevant radiological anatomy and a review of various causes of epistaxis, with the emphasis on the endovascular treatment.

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“…The floor of the nose, the palate, is vascularized by the major palatine artery (MPA), branching off the distal maxillary artery. KP = Kiesselbach plexus [ 6 7 ].…”

Section: Relevant Vascular Anatomy Of the Nosementioning

confidence: 99%

The Endovascular Treatment of Epistaxis

Nicolay

Zijden

Voormolen

et al. 2015

Journal of the Belgian Society of Radiology

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Epistaxis or nosebleed is relatively common in the general population. Depending on the location of the bleeding in the nasal cavity, epistaxis can be divided in two types: anterior or posterior type. The anterior type is far more frequent, often self-limiting and, if needed, is relatively easy treatable. Posterior type epistaxis is rare and more likely to require medical attention. The cornerstone of the conservative therapy of posterior epistaxis is nasal packing. Only in patients with persistent or recurrent epistaxis, endovascular intervention or surgery is indicated. Both treatment options have a similar success and complication rate, but endovascular treatment, if feasible, has several advantages above surgical treatment. The choice of procedure should be made on a patient-to-patient basis, taking several parameters into account.In this pictorial essay we present an overview of the relevant radiological anatomy and a review of various causes of epistaxis, with the emphasis on the endovascular treatment.

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Epistaxis

Abstract: Embolization can play an important role in controlling epistaxis. However, one must be careful to avoid nontarget embolization via the dangerous anastomoses between the ECA branches, the carotid siphon, and ophthalmic arteries.

Cited by 66 publications

References 6 publications

Radiological Diagnosis and Management of Epistaxis

Radiological Diagnosis and Management of Epistaxis

36 Endovascular Treatment of Epistaxis

The Endovascular Treatment of Epistaxis

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