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Eur Arch Otorhinolaryngol ; 269(6): 1677-83, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22081095

RESUMO

Management of life-threatening postsurgical bleeding is complex. If conservative or surgical therapy is demanding, an endovascular treatment can be considered. The goal of this study was to evaluate the outcome of endovascular approaches in the diagnosis and therapy of otherwise intractable postoperative haemorrhages with a study design of outcomes research. Charts of all patients with postsurgical bleedings receiving endovascular treatment were reviewed for clinical outcome, complications, and demographic data. 15 patients were identified. They had rhinosurgery (12/15), tonsillectomy (2/15) or transoral tumour debulking (1/15) prior to the endovascular procedure. In more than 70%, the source of bleeding was directly located angiographically and subsequently superselectively embolized. The remaining patients suffered from post-rhinosurgical epistaxis and underwent a bilateral embolization of the sphenopalatine artery. All bleedings were successfully controlled and no procedure-related complication was noted. In conclusion, endovascular treatment of life-threatening postsurgical haemorrhages should be considered if the source of bleeding is unknown or if surgery is difficult and may result in devastating postoperative complications.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Embolização Terapêutica/métodos , Procedimentos Endovasculares/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Hemorragia Pós-Operatória/terapia , Adolescente , Adulto , Idoso , Angiografia , Cateterismo Periférico , Feminino , Artéria Femoral , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
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