Use of percutaneous arterial embolization for treatment of intractable epistaxis in three dogs.

Intractable epistaxis can be a life-threatening condition. Surgical options are presently limited to ligation of the carotid artery. Extensive collateralization develops after occlusion of the carotid artery, so the benefits are likely only transient and the procedure cannot be repeated. In humans, endovascular treatment avoids many of the complications associated with surgery and has a lower recurrence rate than that associated with ligation of the internal maxillary artery. In 3 dogs with intractable epistaxis, embolization of the terminal portion of the maxillary artery was performed with polyvinyl alcohol particles and contrast slurry. Minor, self-limiting bleeding recurred in 1 dog 8 months after surgery; 2 dogs had no important complications or recurrence within a minimum 10-month follow-up time. Results indicate the feasibility of embolization of the terminal branches of the maxillary artery to control epistaxis in dogs that do not require surgery and as a useful adjunctive procedure prior to rhinotomy.