The Endovascular Treatment of Epistaxis

Abstract

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.

Analysis of Endoscopic Sphenopalatine Artery Surgery for Refractory Epistaxis

“…Epistaxis is commonly seen in ENT clinics and is classified as anterior or posterior bleeding. In many cases, anterior nasal bleeding occurs from the Kiessel-bach's plexus anatomically [15]. This bleeding area is easy to treat in many cases due to the ease of visibility and accessibility of the area when using surgical tools.…”

“…However, embolization is associated with such severe complications as blindness, stroke, and facial paralysis [9]. These could occur in cases of significant anastomosis between the vascular territory of the nose and the eye or brain [15]. Embolization is performed only on the arteries of the external carotid branches.…”

Massive recurrent epistaxis in traumatic pseudoaneurysm of sphenopalatine artery: Report of 2 cases

“…However, some cases can be a surgical emergency because of the amount of blood, repeated episodes, other accompanying symptoms, or the cause [2] . Epistaxis is thought to be idiopathic or essential in 70% of cases; other causes include trauma, surgery, tumors, and malformations [3 , 4] .…”