Epistaxis: The role of arterial embolization
| Autor: | Patrick Dessi, Jean-Michel Bartoli, Vincent Vidal, A Reyre, Laure Santini, Justin Michel, Arthur Varoquaux, Guy Moulin |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Emergency Medical Services Arteriography medicine.medical_specialty Adolescent Sedation medicine.medical_treatment Context (language use) Coronary artery disease Young Adult Embolization Recurrence Intensive care medicine Humans Radiology Nuclear Medicine and imaging Surgical emergency Cooperative Behavior Ligation Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Arterial Embolization Angiography Interventional radiology General Medicine medicine.disease Embolization Therapeutic Surgery Epistaxis CT angiography Female Interdisciplinary Communication medicine.symptom Tomography X-Ray Computed business Internal maxillary and sphenopalatine artery |
| Zdroj: | Diagnostic and Interventional Imaging. 96(7-8):757-773 |
| ISSN: | 2211-5684 |
| DOI: | 10.1016/j.diii.2015.06.006 |
| Popis: | Epistaxis is defined as flow of blood from the nasal fossae and is a common and benign disorder in the great majority of cases which does not require medical care. It may however become a genuine medical or surgical emergency because of the amount, repeated episodes or patient's medical vulnerability (such as coronary artery disease patients). Epistaxis may be either primary or a symptom of an underlying disease. Four levels of problems need to be answered faced with epistaxis: recognizing it, and in particular not missing “epistaxis” due to swallowed blood or venous hemorrhage, which falls outside of the scope of interventional radiology; establishing the amount and its repercussions, particularly as a decompensating factor in another disease; investigating its cause and in particular never missing a tumor (male adolescents); obtaining hemostasis. Epistaxis varies not only in type and cause but must be considered in its clinical context. Arterial embolization is a treatment of choice for severe refractory epistaxis and some hemorrhages. When carried out by trained operators, it is an effective method with few risks of complications and is increasingly being used in reference centers (Brinjikji et al.). It remains, however, a method which is less widely used than surgery, particularly in the United States where in a series of 69,410 patients treated over the last 10 years for refractory epistaxis, 92.6% underwent surgical ligation, 6.4% embolization and 1% combined treatments (Brinjikji et al.). Epistaxis is occasionally catastrophic and requires extremely urgent management. In each case, close collaboration with the surgeon, the presence of an intensive care anesthetist and at least sedation are all factors which improve management and therefore the results of embolization. All patients and/or their friends/close family should have given “reliable, clear and appropriate” information. |
| Databáze: | OpenAIRE |
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