Safety and Efficacy of Transarterial Embolization Therapy in Patients with Uncontrolled Epistaxis: A Single-Center Retrospective Observational Study

Mehrdad Rezaı Mıyandoab; Bilen Onan; Ferhat Can Pişkin; Sinan Sözütok; Elvan Onan

doi:10.36516/jocass.1196446

Clinical Research

Safety and Efficacy of Transarterial Embolization Therapy in Patients with Uncontrolled Epistaxis: A Single-Center Retrospective Observational Study

Year 2023, Volume: 6 Issue: 1, 12 - 18, 30.04.2023

Mehrdad Rezaı Mıyandoab Bilen Onan Ferhat Can Pişkin Sinan Sözütok Elvan Onan

https://doi.org/10.36516/jocass.1196446

Abstract

Aim:
This study aimed to present technical details and outcomes of endovascular treatment of patients who underwent endovascular embolization due to resistant and recurrent epistaxis in our center.
Methods:
In this study, between January 2014 and January 2020, the patients who underwent endovascular treatment due to epistaxis in the interventional radiology unit at our hospital were evaluated retrospectively.
Results:
In this study, 4 (25%) female and 12 (75%) male patients were included in 16 patients. The mean age of the patients was 56.6 ± 17.8 years. The etiologies of epistaxis of the patients were as follows; 4 (25%) patients had nasal angiofibroma, 1 (6.2%) patient had larynx carcinoma, 1 (6.2%) patient had nasopharynx carcinoma, 1 (6.2%) patient had aneurysm rupture, 1 (6.2%) patient had epistaxis due to anticoagulant use, 8 (50%) patients had idiopathic epistaxis. In total, endovascular embolization was performed in all 18 procedures performed. In all 16 patients who underwent embolization, 100% technical success was achieved during the procedure, and no complications developed in the follow-up. However, in 2 (12.5%) procedures, embolization therapy was performed for the second time due to recurrent epistaxis after embolization.
Conclusions:
In resistance and recurrent epistaxis cases, endovascular embolization is an alternative to surgical methods, a treatment method with a low risk of complications and a high success rate.

Keywords

Epistaxis, Endovascular Treatment, Embolization, Interventional Radiology

References

1. Kucik CJ, Clenney T. Management of epistaxis. Am Fam Physician 2005; 71: 305-311. https://www.aafp.org/pubs/afp/issues/2005/0115/p305.html
2. Christensen NP, Smith DS, Barnwell SL et al. Arterial embolization in the management of posterior epistaxis, Otolaryngology-Head and Neck Surgery 2005;133:748-53. https://doi.org/10.1016/j.otohns.2005.07.041
3. Tan LKS, Calhoun KH Epistaxis. Med Clin North Am 1999;83(1):43-56. https://doi.org/10.1016/S0025-7125(05)70086-9
4. Willems PW, Farb RI, Agid R Endovascular treatment of epistaxis. AJNR Am J Neuroradiol. 2009;30:1637-45. https://doi.org/10.3174/ajnr.A1607
5. Pallin DJ, Chng YM, McKay MP, et al. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med 2005; 46: 77-81. https://doi.org/10.1016/j.annemergmed.2004.12.014
6. Gupta AK, Jain S, Singh DP, et al. Epistaxis: Management protocol as per etiology. AIJCR 2009;2:43-6. https://doi.org/10.5005/jp-journals-10013-1009
7. Fatakia A, Winters R, Amedee RG. Epistaxis: a common problem. Ochsner J 2010; 10:176-8.
8. Tuncer I, Doganay L, Ozturk O. Instant control of fundal variceal bleeding with a folkloric medicinal plant extract: Ankaferd Blood Stopper. Gastrointest Endosc. 2009;11:16. https://doi.org/10.1016/j.gie.2009.08.021
9. Huizing EH, de Groot JAM (1003). Basics. Functional Reconstructive Nasal Surgery. Thieme Medical Publishers, Stuttgart. 1-55.
10. Chiu T, Dunn JS. An anatomical study of the arteries of the anterior nasal septum. Otolaryngol Head Neck Surg 2006; 134: 33-6. https://doi.org/10.1016/j.otohns.2005.09.005
11. Elahi MM, Parnes LS, Fox AJ, et al. Therapeutic embolization in the treatment of intractable epistaxis. Arch Otolaryngol Head Neck Surg. 1995; 121(1):65-9. https://doi.org/10.1001/archotol.1995.01890010051009
12. Scaramuzzi NS, Walsh RM, Brennan P, et al. Treatment of intractable epistaxis using arterial embolization, Clin. Otolaryngol. 2001; 26, 307-9. https://doi.org/10.1046/j.1365-2273.2001.00476.x
13. Göçer C, Dursun E, Görgülü O, et al. Intractable epistaxis related to cavernous carotid artery pseudoaneurysm: Treatment of a case with covered stent, Auris Naus Larynx 2004;31;275-8. https://doi.org/10.1016/j.anl.2004.03.007
14. Schaitkin B, Strauss M, Houck JR. Epistaxis: Medical versus surgical therapy: comparison of efficacy, complications and economic considerations. Laryngoscope 1987;97;1392-6. https://doi.org/10.1288/00005537-198712000-00003
15. Klotz DA, Winkle MR, Richmon J, et al. Surgical management of posterior epistaxis: A Changing Paradigm, The Laryngoscope September, 2002;112:1577-82. https://doi.org/10.1097/00005537-200209000-00008
16. Mahadevia AA, Murphy KJ, Obray R, et al. Embolization for intractable epistaxis, Techniques in Vascular and Interventional Radiology 2005;8:134-8. https://doi.org/10.1053/j.tvir.2005.10.006
17. Beck R, Sorge M, Schneider A, et al. Current Approaches to Epistaxis Treatment in Primary and Secondary Care. Deutsches Arzteblatt international 2018;115(1-02):12–22. https://doi.org/10.3238/arztebl.2018.0012
18. Gilyoma JM, Chalya PL. Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in Northwestern Tanzania: a prospective review of 104 cases. BMC Ear Nose Throat Disord 2011;5:11-8. https://doi.org/10.1186/1472-6815-11-8
19. Gifford TO, Orlandi ZZ. Epistaxis. Otolaryngologic Clinics of North America 2008; 41(3):525-36. https://doi.org/10.1016/j.otc.2008.01.003
20. Pope LE, Hobbs CG. Epistaxis: an update on current management. Postgrad Med J. 2005;81(955):309-14. https://doi.org/10.1136/pgmj.2004.025007
21. Nikolaou G., Holzmann D, Soyka MB. Discomfort and costs in epistaxis treatment. Eur Arch Otorhinolaryngol 2013;270:2239–44. https://doi.org/10.1007/s00405-012-2339-2
22. Oguni T, Koragi Y, Yasunaga T, et al. Superselective embolization for intractable idiopathic epistaxis, The British Journal of Radiology. 2000;73;1148-53. https://doi.org/10.1259/bjr.73.875.11144790
23. Seidel DU, Remmert S, Brassel F, et al. Superselective microcoil embolization in severe intractable epistaxis: an analysis of 12 consecutive cases from an otorhinolaryngologic and an interventional neuroradiologic point of view. Eur Arch Otorhinolaryngol 2015; 272(11):3317–26. https://doi.org/10.1007/s00405-014-3427-2
24. Hayes SB, Johnson JN, Most Z, et al. Transarterial embolization of intractable nasal and oropharyngeal hemorrhage using liquid embolic agents. J Neurointerv Surg 2015; 7(07):537–41. https://doi.org/10.1136/neurintsurg-2014-011101

Kontrol Edilemeyen Burun Kanamasi Olan Hastalarda Transarteriyel Embolizasyon Tedavisinin Güvenliği Ve Etkinliği: Tek Merkezli Retrospektif Gözlemsel Bir Çalişma

Year 2023, Volume: 6 Issue: 1, 12 - 18, 30.04.2023

Mehrdad Rezaı Mıyandoab Bilen Onan Ferhat Can Pişkin Sinan Sözütok Elvan Onan

https://doi.org/10.36516/jocass.1196446

Abstract

Amaç:
Bu çalışmanın amacı, merkezimizde dirençli ve tekrarlayan burun kanaması nedeniyle endovasküler embolizasyon uygulanan hastaların endovasküler tedavisinin teknik detaylarını ve sonuçlarını sunmaktır.
Gereç ve Yöntem: Bu çalışmada Ocak 2014-Ocak 2020 tarihleri arasında hastanemizde girişimsel radyoloji ünitesinde burun kanaması nedeniyle endovasküler tedavi uygulanan hastalar retrospektif olarak değerlendirildi.
Bulgular:
Bu çalışmada toplam 16 hastaya 4 (%25) kadın, 12 (%75) erkek hasta dahil edildi. Hastaların yaş ortalaması 56.6 ± 17.8 idi. Hastaların burun kanaması etiyolojileri şöyleydi; 4 (%25) hastada nazal anjiyofibroma, 1 (%6.2) hastada gırtlak karsinomu, 1 (%6.2) hastada nazofarenks karsinomu, 1 (%6.2) hastada anevrizma rüptürü, 1 (%6.2) hastada burun kanaması nedeniyle burun kanaması vardı. antikoagülan kullanımı için 8 (% 50) hastada idiyopatik burun kanaması vardı. Toplamda, 18 prosedürün hepsinde endovasküler embolizasyon yapıldı.
Sonuç:
Dirençli ve tekrarlayan burun kanaması vakalarında endovasküler embolizasyon cerrahi yöntemlere alternatif, komplikasyon riski düşük ve başarı oranı yüksek bir tedavi yöntemidir.

Keywords

Burun Kanaması, Endovasküler Tedavi, Embolizasyon, Girişimsel Radyoloji

References

1. Kucik CJ, Clenney T. Management of epistaxis. Am Fam Physician 2005; 71: 305-311. https://www.aafp.org/pubs/afp/issues/2005/0115/p305.html
2. Christensen NP, Smith DS, Barnwell SL et al. Arterial embolization in the management of posterior epistaxis, Otolaryngology-Head and Neck Surgery 2005;133:748-53. https://doi.org/10.1016/j.otohns.2005.07.041
3. Tan LKS, Calhoun KH Epistaxis. Med Clin North Am 1999;83(1):43-56. https://doi.org/10.1016/S0025-7125(05)70086-9
4. Willems PW, Farb RI, Agid R Endovascular treatment of epistaxis. AJNR Am J Neuroradiol. 2009;30:1637-45. https://doi.org/10.3174/ajnr.A1607
5. Pallin DJ, Chng YM, McKay MP, et al. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med 2005; 46: 77-81. https://doi.org/10.1016/j.annemergmed.2004.12.014
6. Gupta AK, Jain S, Singh DP, et al. Epistaxis: Management protocol as per etiology. AIJCR 2009;2:43-6. https://doi.org/10.5005/jp-journals-10013-1009
7. Fatakia A, Winters R, Amedee RG. Epistaxis: a common problem. Ochsner J 2010; 10:176-8.
8. Tuncer I, Doganay L, Ozturk O. Instant control of fundal variceal bleeding with a folkloric medicinal plant extract: Ankaferd Blood Stopper. Gastrointest Endosc. 2009;11:16. https://doi.org/10.1016/j.gie.2009.08.021
9. Huizing EH, de Groot JAM (1003). Basics. Functional Reconstructive Nasal Surgery. Thieme Medical Publishers, Stuttgart. 1-55.
10. Chiu T, Dunn JS. An anatomical study of the arteries of the anterior nasal septum. Otolaryngol Head Neck Surg 2006; 134: 33-6. https://doi.org/10.1016/j.otohns.2005.09.005
11. Elahi MM, Parnes LS, Fox AJ, et al. Therapeutic embolization in the treatment of intractable epistaxis. Arch Otolaryngol Head Neck Surg. 1995; 121(1):65-9. https://doi.org/10.1001/archotol.1995.01890010051009
12. Scaramuzzi NS, Walsh RM, Brennan P, et al. Treatment of intractable epistaxis using arterial embolization, Clin. Otolaryngol. 2001; 26, 307-9. https://doi.org/10.1046/j.1365-2273.2001.00476.x
13. Göçer C, Dursun E, Görgülü O, et al. Intractable epistaxis related to cavernous carotid artery pseudoaneurysm: Treatment of a case with covered stent, Auris Naus Larynx 2004;31;275-8. https://doi.org/10.1016/j.anl.2004.03.007
14. Schaitkin B, Strauss M, Houck JR. Epistaxis: Medical versus surgical therapy: comparison of efficacy, complications and economic considerations. Laryngoscope 1987;97;1392-6. https://doi.org/10.1288/00005537-198712000-00003
15. Klotz DA, Winkle MR, Richmon J, et al. Surgical management of posterior epistaxis: A Changing Paradigm, The Laryngoscope September, 2002;112:1577-82. https://doi.org/10.1097/00005537-200209000-00008
16. Mahadevia AA, Murphy KJ, Obray R, et al. Embolization for intractable epistaxis, Techniques in Vascular and Interventional Radiology 2005;8:134-8. https://doi.org/10.1053/j.tvir.2005.10.006
17. Beck R, Sorge M, Schneider A, et al. Current Approaches to Epistaxis Treatment in Primary and Secondary Care. Deutsches Arzteblatt international 2018;115(1-02):12–22. https://doi.org/10.3238/arztebl.2018.0012
18. Gilyoma JM, Chalya PL. Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in Northwestern Tanzania: a prospective review of 104 cases. BMC Ear Nose Throat Disord 2011;5:11-8. https://doi.org/10.1186/1472-6815-11-8
19. Gifford TO, Orlandi ZZ. Epistaxis. Otolaryngologic Clinics of North America 2008; 41(3):525-36. https://doi.org/10.1016/j.otc.2008.01.003
20. Pope LE, Hobbs CG. Epistaxis: an update on current management. Postgrad Med J. 2005;81(955):309-14. https://doi.org/10.1136/pgmj.2004.025007
21. Nikolaou G., Holzmann D, Soyka MB. Discomfort and costs in epistaxis treatment. Eur Arch Otorhinolaryngol 2013;270:2239–44. https://doi.org/10.1007/s00405-012-2339-2
22. Oguni T, Koragi Y, Yasunaga T, et al. Superselective embolization for intractable idiopathic epistaxis, The British Journal of Radiology. 2000;73;1148-53. https://doi.org/10.1259/bjr.73.875.11144790
23. Seidel DU, Remmert S, Brassel F, et al. Superselective microcoil embolization in severe intractable epistaxis: an analysis of 12 consecutive cases from an otorhinolaryngologic and an interventional neuroradiologic point of view. Eur Arch Otorhinolaryngol 2015; 272(11):3317–26. https://doi.org/10.1007/s00405-014-3427-2
24. Hayes SB, Johnson JN, Most Z, et al. Transarterial embolization of intractable nasal and oropharyngeal hemorrhage using liquid embolic agents. J Neurointerv Surg 2015; 7(07):537–41. https://doi.org/10.1136/neurintsurg-2014-011101

There are 24 citations in total.

Details

Primary Language	English
Subjects	Otorhinolaryngology
Journal Section	Articles
Authors	Mehrdad Rezaı Mıyandoab 0000-0001-9261-1420 Bilen Onan 0000-0002-1486-2782 Ferhat Can Pişkin 0000-0003-4092-1077 Sinan Sözütok 0000-0003-3626-2312 Elvan Onan 0000-0003-1018-3464
Publication Date	April 30, 2023
Acceptance Date	January 16, 2023
Published in Issue	Year 2023 Volume: 6 Issue: 1

Cite

APA	Rezaı Mıyandoab, M., Onan, B., Pişkin, F. C., Sözütok, S., et al. (2023). Safety and Efficacy of Transarterial Embolization Therapy in Patients with Uncontrolled Epistaxis: A Single-Center Retrospective Observational Study. Journal of Cukurova Anesthesia and Surgical Sciences, 6(1), 12-18. https://doi.org/10.36516/jocass.1196446

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