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Embolization Therapy of Epistaxis


Authors: M. Šercl 1;  V. Šerclová 2;  H. Havrdová 3;  V. Mellanová 1;  V. Machačka 1;  L. Endrych 1
Authors‘ workplace: RDG oddělení Krajská nemocnice Liberec a. s. 1;  ORL oddělení Městská nemocnice Jablonec nad Nisou 2;  ORL oddělení Krajská nemocnice Liberec a. s. 3
Published in: Otorinolaryngol Foniatr, 68, 2019, No. 2, pp. 79-85.
Category: Original Article

Overview

Objective: Objective of this study is to retrospectively evaluate a cohort of patients with intractable epistaxis treated by endovascular embolization.

Methods: A total number of 311 patients with intractable epistaxis were admitted in Liberec Regional Hospital and Jablonec nad Nisou City Hospital between 2009 and 2017, out of these 31 were managed by endovascular treatment. Risk factors, type of embolization therapy, clinical outcome and complications were reviewed retrospectively.

Results: In our cohort of 31patients clinical success rate of the first embolization attempt was 83.9%, which increased to 96.8% following escalation of the embolization extent. In one case we had to abandon the procedure due to technical issues. We encountered one major permanent complication (2.6%), one major transient complication (2.6%), which was managed at the time of the procedure with a complete resolution of clinical symptoms and a total number of 4 minor transient complications (10,6%) – one septal decubitus, which healed within 4 weeks after the procedure, and three cases of headache, which was managed by analgesia. Early recurrence rate was 16.1%, in all cases managed by re-embolization. Failure of endovascular treatment which necessitated surgery was encountered in 3.2% cases.

Conclusion: Endovascular treatment proves to be an effective tool in management of retractable epistaxis. It offers a good risk-benefit profile and is easily repeated should the first attempt not be successful.

Keywords:

posterior nasal packing – epistaxis – maxillary artery


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