Efficacy of transarterial embolization therapy in patients with uncontrollable epistaxis: a single center retrospective observational study

Epistaxis is a condition that is seen with a frequency of approximately 60% in the society, and is mostly asymptomatic and does not require hospital admission. The etiology of epistaxis includes traumas, tumors, vascular malformation, drug use, inflammatory events, bleeding and coagulation disorders, and it is frequently idiopathic. In the treatment of epistaxis, methods such as compression on the nasal wings, medical treatments, cauterization, anterior and posterior nasal packing can be used, and in cases where there is no response to these treatments, embolization treatment comes to the fore as an alternative treatment. In this study, the etiological factors, characteristics of the invasive procedure, complications and the results of the procedures belonging to the patients who underwent endovascular treatment due to epistaxis between January 2014 and January 2020 in the Interventional Radiology Department of Çukurova University Balcalı Training and Research Hospital were examined. In our study, the data of 14 procedures belonging to 12 patients whose data were fully accessed were examined. 33,3% of the patients included in our study were female and 66,6% were male. It was found that the age distribution of our patients varied between 20 and 74 years, and the average age was 56,6±17,8 years. Considering the distribution of patients according to their diagnosis, 16.6% (n=2) had nasal angiofibroma, 8.3% (n=1) larynx carcinoma, 8.3% (n=1) nasopharyngeal carcinoma, 8.3% was determined that 1 (n=1) had aneurysm rupture, 8.3% (n=1) had epistaxis due to anticoagulant use, 66.6% (n=8) were idiopathic epistaxis. Embolization was performed in all 14 procedures. In all 12 patients who underwent embolization, the procedure was completed with 100% success, and no complications developed. Endovascular embolization was applied for the second time due to recurrent epistaxis in two procedures and it was successful. In addition, no complications were found in any procedure. When the literature is reviewed, the high success rate and low complication rate of endovascular therapy, whose use has gradually increased in recent years. According to the data we obtained in our study, it was concluded that endovascular embolization is a low-risk and high success rate in resistant and recurrent epistaxis cases as an alternative to surgical methods.