Clinical Application of Embolization in Intractable Epistaxis

Objective To investigate selective angiography diagnosis and superselective embolization in intractable epistaxis.Methods Under femoral artery puncture and catheter introducer leaving,bilateral common carotid artery angiography was pertormed with 4F Head-Hunt or simmons angiographic catheter.We superselectively inserted the catheter to the branch of external carotid artery after confirming the bleeding site,hemorrhagic artery and external-internal cranial dangerous anastomoses.Sponge gelfoam was used for embolic agents till completely emboliza tionarrived.Results The angiography of 8 epistaxis patients revealed bleeding artery from internal maxillary and facial artery branch.The nasal packingwere taken away immediately after the embolization,without bleeding.All the patients discharged after3~10 hospital observation,no recurrent with follow-up 2~30 months.Facialpain,swelling,limitation of open mouth,low fever appeared and released bysymptomatic treatment.No serous complication occured in this group.Conclusion Selective external carotid artery branch embolization is a safe,simple,effective and rapidmethod in the treatment with refractory epistaxis.