Endovascular treatment of intractable epistaxis - Results of a 4-year local audit

Abstract

Objective. Transcatheter embolisation is an accepted and effective treatment for intractable epistaxis. We analysed our success and complication rates and compared these with results from other published series. Design. Retrospective review. Setting. Unitas Interventional Unit, Centurion. Methods. Case record review (57 procedures) and telephonic interviews (36 traceable respondents). Outcome measures. A numerical audit of the success and complication rates for embolisation procedures performed during the 4-year period between July 1999 and June 2003. Results. A total of 57 endovascular embolisation procedures were performed for intractable epistaxis in 51 patients during this period. Eight patients (15.7%) developed a re-bleed between 1 and 33 days after embolisation, of whom 5 were re-embolised, giving a primary short-term success rate of 86.3% and secondary assisted success rate of 94.1%. Thirty-five of 36 respondents (97.2%) reported no further epistaxis during the long-term follow-up period of 1 - 47 months. The mortality rate was 0%, the major morbidity rate was 2% (1 stroke) and the minor morbidity rate was 25%. Conclusion. Our success and complication rates are acceptable and compare favourably with those reported in other large series.