Microcatheter Embolization of Intractable Idiopathic Epistaxis

Journal Article · Mon Nov 15 04:00:00 EST 1999 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S002709900439· OSTI ID:21080261

Leppaenen, Martti; Seppaenen, Seppo ^[1]; Laranne, Jussi ^[2]; Kuoppala, Katriina ^[3]

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1. Department of Radiology, Tampere University Hospital, P.O. Box 2000, FIN-33521 Tampere (Finland)
2. Department of Otolaryngology, Tampere University Hospital, P.O. Box 2000, FIN-33521 Tampere (Finland)
3. Department of Neurology, Seinaejoki Central Hospital, Hanneksenrinne 7, FIN-60220 Seinaejoki (Finland)

Purpose: To assess the efficacy and safety of microcatheter embolization in the treatment of intractable idiopathic epistaxis. Methods: Thirty-seven patients underwent microcatheter embolization in 1991-1998. We evaluated retrospectively the technical and clinical outcome, the number of complications, the duration of embolization in each case, and the number of blood transfusions needed. All embolizations were done with biplane digital subtraction angiography (DSA) equipment. The procedure was carried out under local anesthesia using transfemoral catheterization, except in one case where the translumbar route was used. Tracker 18 or 10 microcatheters were advanced as far as possible to the distal branches of the sphenopalatine artery. Polyvinyl alcohol (PVA) particles were used for embolization in most cases, while platinum coils or a combination of these two materials were occasionally used. The primary outcome was always assessed immediately by angiography. Follow-up data were obtained from patient records, by interviewing patients on the telephone or by postal questionnaires when necessary. The mean follow-up time was 21 months. Results: The embolization was technically successful in all 37 cases. A curative outcome was achieved in 33 cases (89%). The mean duration of the procedure was 110 min. Four patients (8%) had mild transient complications, but no severe or persistent complications were encountered. Twenty-three patients needed a blood transfusion. Slight rebleeding occurred in three patients during the follow-up; all responded to conservative treatment. One patient suffered two episodes of rebleeding within 2 months after primary embolization. Re-embolizations successfully stopped the bleeding. Conclusion: Embolization is the primary invasive modality for treating intractable idiopathic epistaxis. It proved both safe and effective over a relatively long follow-up.

• OSTI ID: 21080261
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 6 Vol. 22; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANESTHESIA
ARTERIES
BIOMEDICAL RADIOGRAPHY
BLOOD
PATIENTS
PVA
VASCULAR DISEASES