Division of Interventional Neuroradiology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, CA 90095-7437, USA.
Neuroradiology. 2012 Nov;54(11):1241-4. doi: 10.1007/s00234-011-0999-z. Epub 2011 Dec 30.
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.
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.
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.
Trans-radial embolization for epistaxis was a safe and effective method for the patient with end-stage liver disease and resultant severe coagulopathy.
由于与动脉入路相关的出血性并发症的固有风险，患有出血性疾病的患者的鼻出血的血管内治疗具有挑战性。我们描述了经桡动脉入路在终末期肝病和严重凝血功能障碍导致的鼻出血的血管内栓塞中的应用。
两名等待肝移植的患者在积极纠正凝血功能障碍和鼻腔填塞后仍持续鼻出血。在进行 Allen 试验后，对两名患者均进行经桡动脉栓塞鼻出血。
用颗粒栓塞双侧上颌动脉后，鼻出血完全停止。桡动脉入路部位手动压迫 1 小时，然后加压包扎 12 小时。鼻出血的停止有助于随后纠正凝血功能障碍的治疗。动脉穿刺无相关并发症。
对于终末期肝病和严重凝血功能障碍的患者，经桡动脉栓塞鼻出血是一种安全有效的方法。
