Transcatheter arterial embolization for intractable epistaxis secondary togunshot wounds

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization fo r intractable epistaxis secondary to gunshot wounds. MATERIALS AND METHODS: Seven patients with intractable epistaxis secondary to penetrating trauma (gunshot wounds) were studied with angiography and su bsequently underwent embolization with particles (polyvinyl alcohol, gelati n sponge) and/or microcoils, Clinical follow-up included standard hemodynam ic monitoring, serial hematocrit determinations, and clinical observation f or recurrent bleeding. RESULTS: Diagnostic angiography demonstrated evidence of acute arterial inj ury in all patients, All patients subsequently underwent embolization to co mplete angiographic stasis, Two patients had persistent bleeding following embolization. One of these patients required maintenance of his nasal packi ng for 7 days after embolization; no blood products were required during th is time. The second patient's bleeding resolved following correction of his coagulopathy, No complications occurred in any of the patients. CONCLUSIONS: Transcatheter arterial embolization for epistaxis secondary to gunshot wounds is efficacious in the acute setting when conservative manag ement fails.