EMBOLIZATION THERAPY IN SEVERE HEAD AND N ECK HEMORRHAGE

Purpose: To analyse the use of transcatheter embolisation. Material an d methods: We report on 43 patients treated by transcatheter embolisat ion for head and neck haemorrhage from 1987 to 1995. There were 13 pat ients with idiopathic untractable epistaxis, 6 with iatrogenic and thr ee with traumatic bleeding, 7 patients with bleeding from vascular mal formations, 12 patients with haemorrhage from tumours, one ruptured an eurysm of the inferior thyroid artery and one patient bleeding from a retrolingual dystopic goitre. Results: In 11/13 patients with idiopath ic epistaxis, this could be stopped. In 8/9 of the traumatic and iatro genic bleedings the haemorrhage was treated by embolisation alone. In two cases additional elective surgical interventions were necessary. I n 6/7 patients with vascular malformations embolisation resulted in lo ng-lasting periods free from bleeding. Palliative embolisation in blee ding tumours resulted in haemostasis in 10/12 patients. Bleeding was d efinitely stopped in a patient with aneurysm of the inferior thyroidal artery as well as in a patient with bleeding from a dystopic goitre. We observed a total of three complications, two transitory neurologica l disturbances and one permanent amaurosis. Conclusion: Transcatheter embolisation is an effective tool in the treatment of life-threatening head and neck bleedings.