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Results of epistaxis embosurgery using detachable platinum fibered coils
  1. Walter S Lesley1,2,3,4,
  2. Rajesh Rangaswamy1,3,4,
  3. Delip V Patel1
  1. 1Department of Radiology, Scott & White Clinic, Temple, Texas, USA
  2. 2Department of Surgery, Scott & White Clinic, Temple, Texas, USA
  3. 3Department of Neurosurgery, Scott & White Clinic, Temple, Texas, USA
  4. 4Division of Neuroradiology, Section of NeuroInterventional Surgery, Scott & White Clinic, Temple, Texas, USA
  1. Correspondence to Dr Walter S Lesley, Scott & White Clinic, Department of Radiology, 2401 South 31st Street, Temple, TX 76508, USA

Abstract

Background Safety and efficacy outcomes are lacking for embosurgery of the distal internal maxillary artery (IMax) using detachable platinum fibered coils (DPFCs) in patients with uncontrollable epistaxis.

Methods A retrospective analysis was conducted on patients treated October 2006 through May 2009 with a diagnosis of uncontrollable or recurrent epistaxis managed by DPFC. Inclusion criteria included patients with epistaxis complicating open or endoscopic nasal surgery, or patients with the following covariant risk factors: aspirin, clopidogrel, warfarin, ibuprofen or hypertension. Patients were excluded if particulates, liquid glue or non-permanent embolics were used as adjuvants. Medical record review and follow-up for 1 month were performed on all patients to determine treatment results and complications.

Results A cohort of 20 patients meeting enrollment criteria was comprised of 13 men and 7 women with a mean age of 63 years (range 35–85 years). Epistaxis etiologies included recent nasal surgery (N=2) while all patients (N=20) had one or more covariant epistaxis risk factors. 17 patients underwent bilateral IMax embolization. Three patients had unilateral IMax embosurgery in which two patients had a remote history of contralateral IMax open ligation for previous epistaxis. 95% of the cohort remained free of recurrent nose bleeding requiring medical or surgical intervention. 95% of the patients had no complications while one patient (5%) had transient unilateral facial pain. There was no procedure-related death, blindness or stroke. One patient died during follow-up from unrelated causes.

Conclusion DPFC embosurgery is effective and safe in managing uncontrollable epistaxis.

  • Nasal cavity
  • hemorrhage
  • coil
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Footnotes

  • Linked articles 002204.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Scott & White Clinic/Texas A&M HSC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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