Embolization for control of refractory posterior epistaxis

ObjectivesMany methods are included in the treatment of intractable epistaxis including selective embolization. We report our experience with 10 patients treated with this technique.Patients and methodsTen patients with posterior idiopathic epistaxis were selected in this study. They were managed by double-balloon device followed by embolization.ResultsStudy included six males and four females, their age ranged from 49 to 66 years (mean 56 years). Four patients were hypertensive, two were smokers. Epistaxis was unilateral in six patients and bilateral in four. Six internal maxillary and eight sphenopalatine arteries were embolized with polyvinyl alcohol 150–250 μm. Bleeding stopped in all patients after procedure. One patient had recurrent attack 2 months later for whom re-embolization successfully stopped bleeding. No major complications encountered but minor complications occurred in two patients (one severe headache and one transient left temporofacial pain).ConclusionSelective embolization is a clinically effective treatment for severe refractory posterior epistaxis. By this method we can avoid the complications of repeated packs and surgery especially in elderly patients.