Abstract
We herein report the findings of a 74-year-old male with intractable epistaxis. The bleeding point was unknown and epistaxis could not be controlled by conventional packing and Bellocq's tampon method. MR angiography revealed a low blood flow in the left internal carotid artery (ICA). Angiography by Seldinger's procedure revealed 99% stenosis of the left ICA and a moderate blush of the sphenopalatine artery. We consider the cause of intractable epistaxis to be a high blood flow of the external carotid artery due to ICA stenosis. We performed a selective embolization of the sphenopalatine artery using a coil and the treatment was successful. No recurrent epistaxis has been observed in the patient for 1 year. Selective intraarterial embolization is thus considered to be an effective therapy for intractable severe epistaxis.
