INTRODUCTION: Endovascular treatment of epistaxis in patients with bleeding disorders is challenging due to the intrinsic risk of hemorrhagic complication related to the arterial access. We describe the use of trans-radial approach for the endovascular embolization of epistaxis due to end-stage liver disease and resultant severe coagulopathy. METHODS: Two patients waiting for liver transplant continued to have epistaxis despite the aggressive correction of the coagulopathy and nose packing. After performing the Allen's test, trans-radial embolization of the epistaxis was performed in both patients. RESULTS: The complete cessation of epistaxis was achieved after the trans-radial embolization of bilateral maxillary arteries with particles. The radial access sites were manually compressed for 1 h, followed by a compression dressing for 12 h. The cessation of the epistaxis helped the subsequent treatment of correcting the coagulopathy. There was no complication related to the arterial puncture. CONCLUSION: Trans-radial embolization for epistaxis was a safe and effective method for the patient with end-stage liver disease and resultant severe coagulopathy.
INTRODUCTION: Endovascular treatment of epistaxis in patients with bleeding disorders is challenging due to the intrinsic risk of hemorrhagic complication related to the arterial access. We describe the use of trans-radial approach for the endovascular embolization of epistaxis due to end-stage liver disease and resultant severe coagulopathy. METHODS: Two patients waiting for liver transplant continued to have epistaxis despite the aggressive correction of the coagulopathy and nose packing. After performing the Allen's test, trans-radial embolization of the epistaxis was performed in both patients. RESULTS: The complete cessation of epistaxis was achieved after the trans-radial embolization of bilateral maxillary arteries with particles. The radial access sites were manually compressed for 1 h, followed by a compression dressing for 12 h. The cessation of the epistaxis helped the subsequent treatment of correcting the coagulopathy. There was no complication related to the arterial puncture. CONCLUSION: Trans-radial embolization for epistaxis was a safe and effective method for the patient with end-stage liver disease and resultant severe coagulopathy.
Authors: Sanjit S Jolly; Salim Yusuf; John Cairns; Kari Niemelä; Denis Xavier; Petr Widimsky; Andrzej Budaj; Matti Niemelä; Vicent Valentin; Basil S Lewis; Alvaro Avezum; Philippe Gabriel Steg; Sunil V Rao; Peggy Gao; Rizwan Afzal; Campbell D Joyner; Susan Chrolavicius; Shamir R Mehta Journal: Lancet Date: 2011-04-04 Impact factor: 79.321
Authors: Marine Camus; Dennis M Jensen; Jason D Matthews; Gordon V Ohning; Thomas O Kovacs; Rome Jutabha; Kevin A Ghassemi; Gustavo A Machicado; Gareth S Dulai Journal: World J Gastroenterol Date: 2014-10-14 Impact factor: 5.742