Artery Embolization in epistaxis

Abstract

Epistaxis constitutes a frequent emergency in otolaryngology. At emergency wards in hospitals and clinics there are patients daily suffering from nasal hemorrhage associated or secondary to arterial hypertension, facial traumatisms or tumoral processes of the facial region. Generally, in great part of them, the anterior and/or posterior obturation is the most effective therapy and the hemorrage is quickly controlled. However, there are patients who due to the characteristics of their clinical situation or traumatic vascular damages, require a more aggressive handling to control in a definite way this urgency situation. Arterial embolization of the inner maxillary artery constitutes an efficient alternative to control in a definite way the recurrent or incoercible nasal hemorrages. Given the particular irrigation of the facial region, that allows access to a big amount of collateral circulation, it is possible to apply this procedure without risks to the facial irrigation, which requires the support of invasive imagery in the hands of an experimented operator. Three clinical cases are described, of patients with severe epistaxis, with trauma due to projectile and tumor in the maxillary cavity, who required as a final alternative, the embolization of the inner maxillary artery. The technique and results obtained are described.