Selective transcatheter arterial embolization for intractable epistaxis

Objective To analyze the angiographic characteristics of epistaxis,and to observe the clinical effect,complications and concerning precautions of selective transcatheter arterial embolization for the treatment of intractable epistaxis.Methods Digital subtraction angiography(DSA) of external and/or internal carotid artery were performed in 16 patients with intractable epistaxis,and then the maxillary and/or facial artery were embolized with Gelfoam and/or coils.Results DSA showed abnormalities in 15 patients.Embolization resulted in immediate hemostasis in 14 cases.Hemorrhage was controlled in the other 2 cases after ethmoidal artery ligation the next day.No serious complications occurred after selective arterial embolization.Conclusion Selective transcatheter arterial angiography and embolization are effective in the diagnosis and treatment of intractable epistaxis.However,for epistaxis due to ethmoidal artery,the ligation of bleeding artery is necessory.