Endovascular embolization for the management of oronasal cavity hemorrhage / 介入放射学杂志

ABSTRACT

Objective To evaluate the efficacy of transcatheter arterial embolization (TAE) in treating oronasal cavity hemorrhage,and to discuss the the occurrence and prevention of complications.Methods The clinical data of 121 patients with refractory and fatal oronasal cavity hemorrhage,who were admitted to authors' hospital during the period from December 2005 to October 2013 to receive treatment,were retrospectively analyzed.A total of 116 patients were treated with TAE,and these patients were followed up for 1-3 months to evaluate the embolization effect and the occurrence of procedure-related complications was analyzed.Results Of the 116 patients,complete control of bleeding after TAE was achieved in 96 (82.7％),rebleeding within one week after TAE was seen in 19 (16.4％) and the bleeding was controlled by medication,and in the remaining one (0.9％) re-bleeding occurred within one week after TAE and embolization therapy had to be carried out again.No obvious complications occurred in 77 patients (66.4％);maxillofacial pain and numbness,low fever,limitation of mouth opening and other mild complications were observed in 35 patients (30.1％);one patient (0.9％) developed facial skin necrosis and severe headache;and 3 patients (2.6％) showed stroke symptoms due to cerebral embolism.Conclusion For the treatment of refractory and fatal oronasal cavity hemorrhage,TAE can quickly and effectively achieve the purpose of hemostasis;careful selection of proper embolization material based on the the different causes of bleeding and the responsible blood vessels is the key to ensure a successful TAE.The common postoperative complications include postembolization syndrome,local ischemia,local necrosis caused by peripheral ischemia;the main serious complications are skin necrosis of maxillofacial region and cerebral infarction caused by ectopic embolization.