People prone to nosebleeds will probably find that a minimally invasive technique can effectively stave off recurrent episodes, according to a study published in the Journal of NeuroInterventional Surgery, a BMJ peer-reviewed medical publication. Many patients are susceptible to recurrent nosebleeds as a result of nasal surgery or some medications.

Approximately 60% of adults are affected by epistaxis (nosebleeds) at some point in their lives. For individuals who have undergone nasal surgery, as well as those on blood thinners or medications for the treatment of hypertension (high blood pressure), this can be particularly troubling.

In around 6% of cases, recurrent nosebleeds may require “nasal packing,” heat cauterization, or even invasive surgery to stem recurrence, depending on the source of the bleed.

In this study, the scientists assessed how well 13 men and 7 women with uncontrollable nosebleeds responded when treated with endovascular embolisation (embosurgery), using platinum fibre coils, a procedure referred to as DPFC.

The technique uses a fine guide wire or catheter through which to insert detachable platinum coils. These expand into a predetermined shape to slow or block the flow of blood to a major artery-the internal maxillary artery or iMax.

DPFC has been used for the treatment of brain aneurysms and cancerous tumors by cutting off the blood supply. However, it has not been used to treat serious recurrent nosebleeds.

The patients ranged in age from 35 to 85 years (average age 63). Two of them had had recent nasal surgery – they were all vulnerable to nosebleeds as a result of the medication they were taking.

17 out of the 20 patients were treated on both sides of the nose. They were all treated between 2006 and 2009.

The patients were all contacted 30 days after treatment to find out whether they had experienced any further bleedings, or had any problems which may have been associated with the procedure.

19 had not had any further nosebleeds. Just one patient had transient facial pain as a result of the procedure.

The authors said that these results compare very favorably with other current methods used to treat the problem.

“Results of epistaxis embosurgery using detachable platinum fibered coils”
Walter S Lesley, Rajesh Rangaswamy, Delip V Patel
J NeuroIntervent Surg 2010;2:171-175 doi:10.1136/jnis.2009.001834

Written by Christian Nordqvist