Tmj. Siniluoto et al., EMBOLIZATION FOR THE TREATMENT OF POSTERIOR EPISTAXIS - AN ANALYSIS OF 31 CASES, Archives of otolaryngology, head & neck surgery, 119(8), 1993, pp. 837-841
Thirty-one patients with posterior epistaxis refractory to nasal packi
ng alone or in combination with surgical ligation (n=8) underwent diag
nostic angiography and therapeutic embolization of the internal maxill
ary artery. Embolization resulted in the cure of epistaxis in 22 cases
(71.0%). Of the nine failures (29.0%), seven underwent successful sur
gical clipping of the ethmoid arteries, and two were treated conservat
ively and died of their primary hematologic disease within 33 days. La
te rebleeding occurred in two patients: one underwent reembolization a
nd the other was treated surgically. No severe or permanent complicati
ons occurred. The results indicate that embolization is a feasible alt
ernative to surgical intervention for patients with posterior epistaxi
s, and we recommend it as the treatment of choice in cases with high s
urgical risk or failure of prior arterial ligation.