Place of embolization in the treatment of severe epistaxis

Abstract

On the basis of long‐term study on embolization for severe epistaxis, the authors show the different indications and results of this relatively new method; and 54 cases are presented including Rendu‐Osler diseases, primary and traumatic epistaxis, or those due to vascular malformation and benign or malignant tumors. Embolization can prove a very effective method in most cases.

Percutaneous Embolization for Cervicofacial Neoplasms and Hemorrhages

“…As in our retrospective group, 4 of the 6 patients with Rendu-Osler-Weber disease in the cohort of Kramann et al [23] were recurrence free for an average post-discharge follow-up period of over 3 years. These initial success rates are consistent with those of other authors [17,[24][25][26] .…”

Endovascular Treatment of Acute and Subacute Hemorrhage in the Head and Neck

“…1,3,5 In cases of epistaxis from vascular tumors such as angiofibromas, additional angiography and elective preoperative embolization after emergency treatment may be necessary to allow complete preoperative devascularization of the tumor. 5,44,45 In cases of life-threatening intractable bleeding due to traumatic maxillofacial fractures with extensive soft tissue swelling, it is important to perform angiography as soon as possible. Superselective angiography may be required to obtain more detailed information related to the bleeding artery and clarification of the real extent of contrast extravasation; this enables the embolization to be performed as close to the bleeding source as possible.…”

Recurrent Life-Threatening Epistaxis in a Child with Bernard-Soulier Syndrome Controlled by Bilateral Ligation of External Carotids and Ethmoidal Arteries

“…Ethmoidal arteries, if neces sary, can easily be ligated along the medial wall of the orbit. Other measures, such as cryotherapy or arterial embolization, have not gained general consensus or carry an unacceptable risk of severe complications [6], These guide-lines seem well suited for the patients commonly referred to otolaryngologists. In these pa tients, bleeding is usually due to leaks in arterial ves sels secondary to hypertension and/or arteriosclero sis.…”