Embolization for the treatment of idiopathic posterior epistaxis

Background: The goal of this study was to examine safety and efficacy of transarterial embolization for the treatment of idiopathic posterior epistaxis. Methods: A retrospective chart review was conducted to characterize the underlying conditions of eighty-one consecutive patients for whom complete records were available presenting with posterior epistaxis, the associated risk factors for patients with idiopathic posterior epistaxis, and the success rate of embolization in this patient population. Results: One hundred consecutive patients undergoing embolization for epistaxis were identified and 81 patients were included in the analysis. Nineteen patients did not have sufficient and retrievable medical records to be included in the study. Idiopathic posterior epistaxis was the most common underlying etiology of patients with refractory posterior epistaxis (34%). Hypertension, vascular disease, and diabetes were frequently detected comorbid diseases. Patients were equally as likely to be hypertensive as normotensive at the time of presentation (45 and 55%, respectively). Most patients (83%) had failed at least one prior treatment modality. Few patients had a recurrence of epistaxis within 72 hours (three patients [12%]) or had an adverse effect associated with embolization (three patients [12%]). Conclusion: Embolization for the treatment of posterior epistaxis is a safe and effective treatment modality.