Elderly female with epistaxis continuing despited anterior and posterior nasal packing. Embolization was requested. A right external carotid artery injection in the lateral projection shows extravasation from arteries over the "nose" (large arrow). The extravasation is coming from the internal maxillary artery (small arrows). Also note the first branch of the internal maxillary, the middle meningeal artery.
A 3-French microcatheter was used to enter the internal maxillary artery. The injection better shows extravasation from sphenopalatine branches of the internal maxillary artery.
Polyvinyl alcohol particles were used for embolization through the microcatheter. Truncation of the internal maxillary artery indicates a satisfactory embolization. During embolization care is taken to place the catheter beyond the origin of the middle meningeal. This is done in order to minimize the possiblity of non-target embolization into the cranium.
Embolization for Epistaxis |
