| Popis: |
epistaxis is a common condition. Most hemorrhages are mild and self-limiting and will resolve spontaneously. If hemorrhage continues it usually can be controlled by local treatments, including nasal packing or electrocautery. Intractable severe epistaxis may be treated by transarterial embolization. This chapter reviews the clinical relevance, treatment options, relevant anatomy, and etiology of intractable epistaxis. It examines the technique and endovascular equipment need to successfully achieve hemostasis. Close attention is paid to the potentially dangerous anastomoses and vascular anatomy of the skull base, knowledge critical to avoiding the potentially devastating complications of stroke and blindness. A review of the literature shows that one group reported a 97% success rate in a first series of 54 patients with severe epistaxis. Endovascular treatment of epistaxis is considered safe, but serious complications are still possible. Stroke has been reported in patients treated endovascularly for severe epistaxis. Complications include temporofacial pain, headache, soft tissue necrosis, facial paralysis, blindness, and stroke. The use of small calibrated particles has been associated with such complications as soft tissue necrosis and facial paralysis. Intractable epistaxis can be treated by endovascular embolization when conservative and surgical techniques fail to achieve hematosis. Endovascular embolization is a minimally invasive and effective therapy for epistaxis. |
