Endovascular embolization of intractable epistaxis

Chao Bao Luo*, Michael Mu Huo Teng, Jiing Feng Lirng, Feng Chi Chang, Shin Su Chen, Wan You Guo, Cheng Yen Chang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background. We undertook this study to define the role of angiography and endovascular embolization in the treatment of patients with intractable epistaxis. Methods. A series of 19 patients with massive intractable epistaxis, all treated with endovascular embolization were reviewed. There were 15 males and four females ranging in age from 18 to 70 years, with a mean age of 38 years. The predisposing factors of intractable epistaxis were head and neck tumors (n = 11), idiopathic symptoms (n = 3), surgical complications (n = 2), arteriovenous malformation of the face (n = 1), thrombocytopenia (n = 1) and trauma (n = 1). Polyvinyl alcohol (PVA) particles and gelfoam plugs were used as embolic agents in 11 patients for devascularization; detachable balloons with N-butyl-2-cyanoacrylate (NBCA) were used in four patients for vascular occlusion; NBCA and/or coils were used in four patients in the carotid and subclavian arteries for obliteration of pseudoaneurysms. Results. Complete cessation of epistaxis was achieved in all 19 patients immediately after embolization. Seven patients had also undergone surgical tumor removal at two to five days after embolization. Two patients experienced mild to moderate facial pain on the first day after the procedure, but the symptoms later subsided. No significant complication or recurrence was observed in 18 patients. One patient with advanced hypopharyngeal carcinoma died two weeks after embolization due to another episode of massive epistaxis. Clinical follow-up for these patients was 15 days to eight years, with a mean of 41 months. Conclusions. Therapeutic endovascular embolization of intractable epistaxis is both efficient and safe. It should be considered as the primary treatment modality in intractable epistaxis.

Original languageEnglish
Pages (from-to)205-212
Number of pages8
JournalChinese Medical Journal (Taipei)
Issue number3
StatePublished - Mar 2000


  • Endovascular embolization
  • Intractable epistaxis


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