RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00000068.xml
Semin intervent Radiol 2020; 37(02): 150-156
DOI: 10.1055/s-0040-1709156
DOI: 10.1055/s-0040-1709156
Review Article
Endovascular Treatment of Epistaxis
Weitere Informationen
Publikationsverlauf
Publikationsdatum:
14. Mai 2020 (online)
![](https://www.thieme-connect.de/media/sir/202002/lookinside/thumbnails/10-1055-s-0040-1709156_001191-1.jpg)
Abstract
Epistaxis is not uncommon, with up to 60% of the population suffering from at least one episode in their lifetime and as many as 6% presenting for medical attention. An analysis of emergency room (ER) visits in the United States between 2009 and 2011 identified 1.2 million encounters for epistaxis, accounting for 0.32% of ER visits. Approximately 6% of patients will require more aggressive, invasive management in the form of transnasal ligation of the sphenopalatine artery or endovascular embolization. This article reviews the epidemiology, rationale for endovascular treatment, strategy for treatment, endovascular technique, postprocedural follow-up, and complications and their management.
-
References
- 1 Verillaud B, Robard L, Michel J. , et al; SFORL Work-Group. Guidelines of the French Society of Otorhinolaryngology (SFORL). Second-line treatment of epistaxis in adults. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134 (03) 191-193
- 2 Sethi RKV, Kozin ED, Abt NB, Bergmark R, Gray ST. Treatment disparities in the management of epistaxis in United States emergency departments. Laryngoscope 2018; 128 (02) 356-362
- 3 Pallin DJ, Chng YM, McKay MP, Emond JA, Pelletier AJ, Camargo Jr CA. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med 2005; 46 (01) 77-81
- 4 Cooper SE, Ramakrishnan VR. Direct cauterization of the nasal septal artery for epistaxis. Laryngoscope 2012; 122 (04) 738-740
- 5 Shay S, Shapiro NL, Bhattacharyya N. Epidemiological characteristics of pediatric epistaxis presenting to the emergency department. Int J Pediatr Otorhinolaryngol 2017; 103: 121-124
- 6 Sylvester MJ, Chung SY, Guinand LA, Govindan A, Baredes S, Eloy JA. Arterial ligation versus embolization in epistaxis management: counterintuitive national trends. Laryngoscope 2017; 127 (05) 1017-1020
- 7 Robinson AE, McAuliffe W, Phillips TJ, Phatouros CC, Singh TP. Embolization for the treatment of intractable epistaxis: 12 month outcomes in a two centre case series. Br J Radiol 2017; 90 (1080): 20170472
- 8 Reyre A, Michel J, Santini L. , et al. Epistaxis: the role of arterial embolization. Diagn Interv Imaging 2015; 96 (7-8): 757-773
- 9 Marin E, Watelet JB, Gevaert P, Van Zele T. Severe spontaneous epistaxis: retrospective study in a tertiary ENT centre. Eur Arch Otorhinolaryngol 2019; 276 (06) 1693-1699
- 10 Peterson J. Hereditary hemorrhagic telangiectasia management. Radiol Technol 2017; 88 (03) 277-294
- 11 Robard L, Michel J, Prulière Escabasse V. , et al; SFORL Work-Group. Guidelines of the French Society of Otorhinolaryngology (SFORL) (short version). Specific treatment of epistaxis in Rendu-Osler-Weber disease. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134 (01) 37-41
- 12 Makhasana JAS, Kulkarni MA, Vaze S, Shroff AS. Juvenile nasopharyngeal angiofibroma. J Oral Maxillofac Pathol 2016; 20 (02) 330
- 13 Dong F, Li Q, Wu J. , et al. Carotid blowout syndrome after nasopharyngeal carcinoma radiotherapy: successful treatment by internal carotid artery occlusion after stent implantation failure. Springerplus 2016; 5 (01) 1553
- 14 Mak CH, Cheng KM, Cheung YL, Chan CM. Endovascular treatment of ruptured internal carotid artery pseudoaneurysms after irradiation for nasopharyngeal carcinoma patients. Hong Kong Med J 2013; 19 (03) 229-236
- 15 Grandhi R, Brasiliense LBC, Williamson R, Zwagerman NT, Sauvageau E, Hanel RA. Delayed Pipeline embolization of a ruptured true internal carotid artery aneurysm presenting with epistaxis: case report and review of the literature. World Neurosurg 2019; 125: 273-276
- 16 Raper DM, Ding D, Peterson EC. , et al. Cavernous carotid aneurysms: a new treatment paradigm in the era of flow diversion. Expert Rev Neurother 2017; 17 (02) 155-163
- 17 Ozono Y, Nishiike S, Ishihara M, Fujinaka T. Rupture of Internal carotid artery pseudoaneurysm in the sphenoid sinus as a complication of deep neck space infection. J Med Invest 2019; 66 (1.2): 188-189
- 18 Ko JK, Lee SW, Lee TH, Choi CH. Traumatic carotid cavernous fistula with a connection between the supraclinoid internal carotid artery and cavernous sinus via a pseudoaneurysm presenting with delayed life-threatening epistaxis. NMC Case Rep J 2017; 4 (02) 43-46
- 19 Liu QL, Xue H, Qi CJ, Zhao P, Wang DH, Li G. Traumatic anterior cerebral artery pseudoaneurysmal epistaxis. World Neurosurg 2017; 100: 713.e9-713.e16
- 20 De Los Reyes KM, Gross BA, Frerichs KU. , et al. Incidence, risk factors and management of severe post-transsphenoidal epistaxis. J Clin Neurosci 2015; 22 (01) 116-122
- 21 Goljo E, Dang R, Iloreta AM, Govindaraj S. Cost of management in epistaxis admission: Impact of patient and hospital characteristics. Laryngoscope 2015; 125 (12) 2642-2647
- 22 Brinjikji W, Kallmes DF, Cloft HJ. Trends in epistaxis embolization in the United States: a study of the Nationwide Inpatient Sample 2003-2010. J Vasc Interv Radiol 2013; 24 (07) 969-973
- 23 Rudmik L, Leung R. Cost-effectiveness analysis of endoscopic sphenopalatine artery ligation vs arterial embolization for intractable epistaxis. JAMA Otolaryngol Head Neck Surg 2014; 140 (09) 802-808
- 24 Villwock JA, Jones K. Recent trends in epistaxis management in the United States: 2008-2010. JAMA Otolaryngol Head Neck Surg 2013; 139 (12) 1279-1284
- 25 de Bonnecaze G, Gallois Y, Bonneville F, Vergez S, Chaput B, Serrano E. Transnasal endoscopic sphenopalatine artery ligation compared with embolization for intractable epistaxis: a long-term analysis. Am J Rhinol Allergy 2018; 32 (03) 188-193
- 26 Swords C, Patel A, Smith ME, Williams RJ, Kuhn I, Hopkins C. Surgical and interventional radiological management of adult epistaxis: systematic review. J Laryngol Otol 2017; 131 (12) 1108-1130
- 27 Dubel GJ, Ahn SH, Soares GM. Transcatheter embolization in the management of epistaxis. Semin Intervent Radiol 2013; 30 (03) 249-262
- 28 Strach K, Schröck A, Wilhelm K. , et al. Endovascular treatment of epistaxis: indications, management, and outcome. Cardiovasc Intervent Radiol 2011; 34 (06) 1190-1198
- 29 Loon NW, Gendeh BS, Zakaria R, Hamzah JC, Din NM. Ophthalmic artery occlusion following neuro-embolization of the external carotid artery, a case report. BMC Ophthalmol 2017; 17 (01) 92
- 30 Nishimoto K, Minoda R, Yoshida R, Hirai T, Yumoto E. A case of periodontal necrosis following embolization of maxillary artery for epistaxis. Case Rep Otolaryngol 2016; 2016: 6467974
- 31 Khoury NN, Champagne PO, Kotowski M, Raymond J, Roy D, Weill A. Unexpected complications with head and neck hydrogel microsphere particle embolization: a case series and a technical note. Interv Neuroradiol 2017; 23 (01) 107-111
- 32 Gillard M, Archier E, Monnet O. , et al. [Cutaneous foreign body granulomas following cervico-facial arterial embolization: Three cases]. Ann Dermatol Venereol 2018; 145 (11) 659-664
- 33 Seidel DU, Remmert S, Brassel F, Schlunz-Hendann M, Meila D. Superselective microcoil embolization in severe intractable epistaxis: an analysis of 12 consecutive cases from an otorhinolaryngologic and an interventional neuroradiologic point of view. Eur Arch Otorhinolaryngol 2015; 272 (11) 3317-3326
- 34 Hayes SB, Johnson JN, Most Z, Elhammady MS, Yavagal D, Aziz-Sultan MA. Transarterial embolization of intractable nasal and oropharyngeal hemorrhage using liquid embolic agents. J Neurointerv Surg 2015; 7 (07) 537-541
- 35 Al-Samkari H, Kritharis A, Rodriguez-Lopez JM, Kuter DJ. Systemic bevacizumab for the treatment of chronic bleeding in hereditary haemorrhagic telangiectasia. J Intern Med 2019; 285 (02) 223-231
- 36 Iyer VN, Apala DR, Pannu BS. , et al. Intravenous bevacizumab for refractory hereditary hemorrhagic telangectasia-related epistaxis and gastrointestinal bleeding. Mayo Clin Proc 2018; 93 (02) 155-166
- 37 Hsu YP, Hsu CW, Bai CH, Cheng SW, Chen C. Medical treatment for epistaxis in hereditary hemorrhagic telangectasia: a meta-analysis. Otolaryngol Head Neck Surg 2019; 160 (01) 22-35
- 38 Halderman AA, Ryan MW, Marple BF, Sindwani R, Reh DD, Poetker DM. Bevacizumab for epistaxis in hereditary hemorrhagic telangectasia: an evidence-based review. Am J Rhinol Allergy 2018; 32 (04) 258-268
- 39 Steineger J, Geirdal AO, Osnes T, Heimdal KR, Dheyauldeen S. Intranasal bevacizumab injections improve quality of life in HHT patients. Laryngoscope 2019; DOI: 10.1002/lary.28179. [Epub ahead of print]
- 40 Stokes P, Rimmer J. Intranasal bevacizumab in the treatment of HHT -related epistaxis: a systematic review. Rhinology 2018; 56 (01) 3-10
- 41 Riss D, Burian M, Wolf A, Kranebitter V, Kaider A, Arnoldner C. Intranasal submucosal bevacizumab for epistaxis in hereditary hemorrhagic telangiectasia: a double-blind, randomized, placebo-controlled trial. Head Neck 2015; 37 (06) 783-787
- 42 Wojak JC. Epistaxis. In: Prestigiacomo C. , ed. Surgical Endovascular Neuroradiology. New York: Thieme; 2015: 352-359
- 43 Harwood AR, Wojak JC, Barry R. External beam radiotherapy for severe epistaxis from Osler-Weber-Rendu disease. J La State Med Soc 2002; 154 (03) 154-155
- 44 McIntosh DL, Douglas G, Lee K, Allen J, Mahadevan M. External carotid artery blood supply to the orbit. Int J Pediatr Otorhinolaryngol 2007; 71 (10) 1623-1626
- 45 Koh E, Frazzini VI, Kagetsu NJ. Epistaxis: vascular anatomy, origins, and endovascular treatment. AJR Am J Roentgenol 2000; 174 (03) 845-851
- 46 Duncan IC, Dos Santos C. Accessory meningeal arterial supply to the posterior nasal cavity: another reason for failed endovascular treatment of epistaxis. Cardiovasc Intervent Radiol 2003; 26 (05) 488-491