caa a22 4500 606187065 CHVBK 20210128100839.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00405-014-3427-2 doi (NATIONALLICENCE)springer-10.1007/s00405-014-3427-2 Superselective microcoil embolization in severe intractable epistaxis: an analysis of 12 consecutive cases from an otorhinolaryngologic and an interventional neuroradiologic point of view [Elektronische Daten] [D. Seidel, S. Remmert, F. Brassel, M. Schlunz-Hendann, D. Meila] From 2006 to 2013, 12 patients with severe epistaxis refractory to prior conservative and surgical therapy were treated by superselective embolization of nasal arteries. Supersoft platinum microcoils with smallest diameters were used as the sole embolic agent in all cases. Coils were applied far distally in a stretched position for obtaining ideal target vessel superselectivity. The objective of this study is to evaluate efficacy and complications of superselective coil embolization for treatment of severe intractable epistaxis and to discuss results from an otorhinolaryngologic and an interventional neuroradiologic point of view. Retrospectively, all epistaxis inpatients between 2006 and 2013 were identified and subdivided by form of treatment: conservative, surgical and interventional therapy. Medical records of interventionally treated patients were reviewed for demographics, medical history, risk factors, clinical data, complications and short-term success, and patients were followed up for long-term success. Mean follow-up was 37months. In 12 patients, 14 embolizations were carried out, with short-term success in 9 patients (75%), while early post-interventional rebleeding occurred in 3 patients (25%). Of 9 patients with short-term success, 1 died during stay, 1 was lost to follow-up and 1 had minor re-bleeding after 30months. Six patients had short-term and long-term success. Before the first embolization, 3±1 conservative and/or surgical procedures had been undertaken. Length of stay was 12.8±3.6days. 8 patients (67%) received red cell concentrates. Most frequent complications were mucosal damage and nasal pain, but these were related to repeated packing and surgery. Typical embolic complications as neurological or visual impairment or soft tissue necrosis were not observed in any patient. From the otorhinolaryngologic point of view, surgery is the treatment of choice in severe refractory epistaxis, but in case of repeated failure, superselective microcoil embolization is a valuable addition to the therapeutic spectrum. From the interventional neuroradiologic point of view, superselective microcoil embolization is an effective, well tolerable and safe procedure and complications may be reduced in comparison to microparticle embolization. Modern supersoft microcoils with smallest diameters enable ideal superselectivity of the target vessels. Springer-Verlag Berlin Heidelberg, 2014 Intractable epistaxis nationallicence Endovascular intervention nationallicence Sphenopalatine artery nationallicence Internal maxillary artery nationallicence Angiography nationallicence Superselective embolization nationallicence Microcoils nationallicence Complications nationallicence Seidel D. Department of Otorhinolaryngology and Head and Neck Surgery, Malteser Hospital St. Anna, Albertus-Magnus-Straße 33, 47259, Duisburg, Germany aut Remmert S. Department of Otorhinolaryngology and Head and Neck Surgery, Malteser Hospital St. Anna, Albertus-Magnus-Straße 33, 47259, Duisburg, Germany aut Brassel F. Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Zu den Rehwiesen 9, D-47055, Duisburg, Germany aut Schlunz-Hendann M. Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Zu den Rehwiesen 9, D-47055, Duisburg, Germany aut Meila D. Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Zu den Rehwiesen 9, D-47055, Duisburg, Germany aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/11(2015-11-01), 3317-3326 0937-4477 272:11<3317 2015 272 405 https://doi.org/10.1007/s00405-014-3427-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3427-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Seidel D. Department of Otorhinolaryngology and Head and Neck Surgery, Malteser Hospital St. Anna, Albertus-Magnus-Straße 33, 47259, Duisburg, Germany aut NATIONALLICENCE 700 1- Remmert S. Department of Otorhinolaryngology and Head and Neck Surgery, Malteser Hospital St. Anna, Albertus-Magnus-Straße 33, 47259, Duisburg, Germany aut NATIONALLICENCE 700 1- Brassel F. Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Zu den Rehwiesen 9, D-47055, Duisburg, Germany aut NATIONALLICENCE 700 1- Schlunz-Hendann M. Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Zu den Rehwiesen 9, D-47055, Duisburg, Germany aut NATIONALLICENCE 700 1- Meila D. Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Zu den Rehwiesen 9, D-47055, Duisburg, Germany aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/11(2015-11-01), 3317-3326 0937-4477 272:11<3317 2015 272 405