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Main Article Content
Endovascular treatment of intractable epistaxis — results of a 4-year local audit
Abstract
intractable epistaxis in 51 patients over a 4-year period at the Unitas
Interventional Unit near Pretoria. Long-term follow-up was possible in
36 patients. Three cases were due to trauma and 2 directly related to previous facial surgery, 1 patient had hereditary haemorrhagic telangiectasia (HHT), and the remaining 45 cases (88.2%) were classed as idiopathic. Eight patients (15.7%) had a rebleed between 1 and 33 days after the initial embolisation. Four were re-embolised once, 1 was re-embolised twice (the HHT patient), and 2 underwent additional
ethmoid artery ligation (with no further bleeding). This gives a primary
short-term success rate (in all 51 cases) of 86.3% and a secondary
assisted success rate of 94.1% for embolisation alone. Long-term follow-
up was obtained in 36 patients, with 35 (97.2%) reporting no further
bleeding after the initial procedure(s). Only the patient with HHT developed
multiple recurrent bleeds. The mortality rate was 0%, the major morbidity
rate 2% (1 stroke), and the minor morbidity rate 25% (N = 36), which
included transient facial pain, headaches and femoral problems related to access. Our results compare favourably with other published series. In conclusion, endovascular embolisation for intractable epistaxis is available locally as an alternative technique for the treatment of this difficult condition.
