EMBOLIZATION FOR THE TREATMENT OF POSTERIOR EPISTAXIS - AN ANALYSIS OF 31 CASES

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.