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Facial necrosis after endovascular Onyx-18 embolization for epistaxis. Surg Neurol Int 2013;4:95

Date

08/21/2013

Pubmed ID

23956938

Pubmed Central ID

PMC3740618

DOI

10.4103/2152-7806.115388

Abstract

BACKGROUND: Evolution in techniques and equipment has expanded the role, effectiveness, and safety of endovascular transarterial embolization for the treatment of severe epistaxis. Risks from this treatment approach include major ischemic complications. To date, there have been only a few reports of soft tissue necrosis following endovascular embolization for severe epistaxis; none involve the use of Onyx-18.

CASE DESCRIPTION: We report the case of a 52-year-old woman who presented with epistaxis that was refractory to medical and surgical management, which lead to endovascular intervention and embolization with Onyx-18. The patient subsequently developed nasal ala and facial necrosis as a result of the procedure.

CONCLUSION: We report the use of Onyx-18 for the endovascular embolization of a patient with severe epistaxis and subsequent complications. In cases of severe epistaxis that warrant intervention in the form of embolization, ischemic complications are rare; however, ischemic complications may be unavoidable and should factor into the discussion regarding procedural risks.

Author List

Grandhi R, Panczykowski D, Zwagerman NT, Gehris R, Villasenor-Park J, Ho J, Grandinetti L, Horowitz M

Author

Nathan Zwagerman MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin