Superselective embolisation for intractable idiopathic epistaxis

Br J Radiol. 2000 Nov;73(875):1148-53. doi: 10.1259/bjr.73.875.11144790.

Abstract

37 patients with intractable idiopathic epistaxis were treated with superselective embolisation between 1995 and 1999. A total of 40 embolisations was performed, including three procedures for recurrence. The embolic material was gelatin sponge in 27 procedures, microcoils in 9 and both gelatin sponge and microcoils in 4. Immediate cessation of nasal bleeding was obtained in all patients after embolisation. Recurrent epistaxis occurred in 2 (5.4%) of the 37 patients within 7 days after initial embolisation, giving a short-term success rate of 94.6%. The long-term follow-up ranged from 1-51 months (mean 21.6 months). Late re-bleeding occurred in two patients, giving a long-term success rate of 94.6%. Two patients underwent re-embolisation; it was necessary to embolise the ipsilateral facial artery and/or the contralateral internal maxillary as well as the ipsilateral maxillary artery. Although the overall complication rate was 45.0%, no major complications occurred. Superselective embolisation with gelatin sponge is an effective and safe treatment technique for intractable idiopathic epistaxis.

MeSH terms

  • Adult
  • Aged
  • Embolization, Therapeutic / methods*
  • Epistaxis / diagnostic imaging
  • Epistaxis / etiology
  • Epistaxis / therapy*
  • Female
  • Gelatin Sponge, Absorbable / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Recurrence
  • Retrospective Studies
  • Risk Factors