THERAPEUTIC EMBOLIZATION IN THE TREATMENT OF INTRACTABLE EPISTAXIS

Objective: To determine the effectiveness of therapeutic embolization in the treatment of intractable epistaxis. Design: Cohort. Setting: Te rtiary care hospital. Patients: Consecutive referred sample of 57 pati ents with intractable epistaxis. Intervention: Percutaneous transfemor al catheterization and angiography of the internal maxillary arteries. Embolization of the most distal branches with 0.1- to 0.9-cm(3) mediu m-sized polyvinyl alcohol particles on the suspected side of bleeding. Outcome: Outcome was successful if no further interventional treatmen t was required for epistaxis. Results: Anatomical abnormalities preclu ded embolization in three patients. Three of the remaining 54 patients required supplementry embolization. Including these three patients, 5 2 (96%) of 54 patients had successful control epistaxis. The major neu rologic complication rate was 6% (three of 54 patients), with no perma nent deficits. Conclusions: Therapeutic embolization is an effective a nd safe technique and should be considered as the primary treatment mo dality in severe epistaxis.