Guidelines of the French Society of Otorhinolaryngology (SFORL). Managing epistaxis under coagulation disorder due to antithrombotic therapy

Escabasse, Virginie; Malard, O.; Crampette, L.; Achache, M.; Lamrani, Moulay Youssef Alaoui; Ardillon, L.; Babin, E.; Sollier, Claire Bal dit; Béquignon, E.; Borsik, M.; Castillo, L.; Coste, A.; Debry, Christian; Dessi, P.; Drouet, Ludovic; Dufour, Xavier; Dupuis‐Girod, Sophie; Faure, Frédéric; Gallet, P.; Guldman, R.; Houdart, E; Jankowski, R.; Jégoux, Franck; Leble, S.; Michel, J.; Mortuaire, G.; Mouchon, E.; Page, C.; Robard, L.; Roux, Adeline; Maurice, Jean; Sarlon, Gabrielle; Strunski, V.; Trévillot, V.; Vérillaud, Benjamin; Vironneau, P.

doi:10.1016/j.anorl.2016.10.001

Cited by 13 publications

(23 citation statements)

References 2 publications

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“…In France, guidelines on the management of epistaxis in patients taking anticoagulants have existed since 2016 (33). In acute epistaxis, these recommend screening for…”

Section: Management Of Patients On Anticoagulantsmentioning

confidence: 99%

“…If the bleeding cannot be halted, stopping antiplatelet therapy while at the same time giving platelet transfusions is an option (33).…”

Section: Antiplatelet Drugsmentioning

confidence: 99%

“…If the vitamin K antagonist has been overdosed and the bleeding can be controlled, the dosage should be altered (33).…”

Section: Vitamin K Antagonistsmentioning

confidence: 99%

“…If bleeding is uncontrolled, dabigatran is the only drug for which an antidote (idarucizumab 5 mg in two consecutive 5-to 10-min intravenous infusions) is currently available (33).…”

Section: Direct Oral Anticoagulantsmentioning

confidence: 99%

“…Anticoagulation treatment should not be altered in a patient about to undergo endovascular embolization (expert opinion) (33).…”

Section: Direct Oral Anticoagulantsmentioning

confidence: 99%

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Current Approaches to Epistaxis Treatment in Primary and Secondary Care

Beck¹,

Sorge²,

Schneider³

et al. 2018

Deutsches Ärzteblatt International

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“…In France, guidelines on the management of epistaxis in patients taking anticoagulants have existed since 2016 (33). In acute epistaxis, these recommend screening for…”

Section: Management Of Patients On Anticoagulantsmentioning

confidence: 99%

“…If the bleeding cannot be halted, stopping antiplatelet therapy while at the same time giving platelet transfusions is an option (33).…”

Section: Antiplatelet Drugsmentioning

confidence: 99%

“…If the vitamin K antagonist has been overdosed and the bleeding can be controlled, the dosage should be altered (33).…”

Section: Vitamin K Antagonistsmentioning

confidence: 99%

“…If bleeding is uncontrolled, dabigatran is the only drug for which an antidote (idarucizumab 5 mg in two consecutive 5-to 10-min intravenous infusions) is currently available (33).…”

Section: Direct Oral Anticoagulantsmentioning

confidence: 99%

“…Anticoagulation treatment should not be altered in a patient about to undergo endovascular embolization (expert opinion) (33).…”

Section: Direct Oral Anticoagulantsmentioning

confidence: 99%

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Current Approaches to Epistaxis Treatment in Primary and Secondary Care

Beck¹,

Sorge²,

Schneider³

et al. 2018

Deutsches Ärzteblatt International

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Posterior epistaxis management: review of the literature and proposed guidelines of the hellenic rhinological-facial plastic surgery society

Koskinas,

Terzis,

Georgalas

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Posterior epistaxis is a common emergency in ENT practice varying in severity and treatment. Many management guidelines have been proposed, all of which are a product of retrospective analyses due to the nature of this pathology, as large-scale double-blind studies are impossible—even unethical—to conduct. The purpose of this review is to perform a thorough analysis and comparison of every treatment plan available and establish guidelines for the best possible outcome in accordance to every parameter studied. Given the extensive heterogeneity of information and the multitude of studies on this topic, along with the comparison of various treatment options, we opted for a literature review as our research approach. Methods A review of the literature was performed using PubMed Database and search terms included “posterior epistaxis”, “treatment”, “management”, “guidelines”, “algorithm” “nasal packing”, “posterior packing”, “surgery”, “SPA ligation”, “embolization”, “risk factors” or a combination of the above. Results Initial patients’ assessment invariably results in most cases in posterior packing. There seems to be a superiority in recent literature of early surgery over nasal packing as a definitive treatment. Embolization is usually used after surgery failure, except for specific occasions. Conclusion Despite the vast heterogeneity of information, there seems to be a need for re-evaluation of the well-established treatment plans according to more recent studies. Graphical abstract

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