PT  - JOURNAL ARTICLE
AU  - Ernst, R J
AU  - Bulas, R V
AU  - Gaskill-Shipley, M
AU  - Tomsick, T A
TI  - Endovascular therapy of intractable epistaxis complicated by carotid artery occlusive disease.
DP  - 1995 Aug 01
TA  - American Journal of Neuroradiology
PG  - 1463--1468
VI  - 16
IP  - 7
4099  - http://www.ajnr.org/content/16/7/1463.short
4100  - http://www.ajnr.org/content/16/7/1463.full
SO  - Am. J. Neuroradiol.1995 Aug 01; 16
AB  - Three cases of intractable spontaneous posterior epistaxis refractory to nasal packing and complicated by ipsilateral carotid artery occlusive disease were successfully treated with internal maxillary artery occlusion with microcoils. There were no complications and no recurrent episodes of epistaxis at a mean follow-up of 12 months. The presence of ipsilateral carotid artery disease requires modification of standard distal internal maxillary artery embolization because of the recruitment of external carotid to internal carotid and external carotid to ophthalmic artery collateral pathways, with subsequent risk of particle embolization of these arterial distributions. Proximal internal maxillary artery microcoil embolization eliminates this risk and is equivalent to surgical internal maxillary artery ligation. This procedure also provides additional information about the internal carotid artery collateral circulation.