[Rendu-Osler-Weber disease. Diagnostic and therapeutic assessment by angiography].

The principal manifestation of Rendu-Osler-Weber disease is epistaxis, associated multiple mucocutaneous localizations generally being asymptomatic. Full advantage does not appear to have been taken of the various possible treatments of epistaxis: though they are all palliative, certain of them provide aleatory effects in relation to others (surgery or radiotherapy and embolization). In consequence, embolization should be the initial procedure, and should be repeated whenever necessary and possible, for all epistaxis requiring hospitalization for transfusion. Results of embolization are improved when no previous therapy has been applied, when the disease has not advanced, and when few localizations, even asymptomatic, exist in the head and neck region. Results are independent of the sex, the duration of the disease, the chronicity of the bleeding episodes, and their frequency and severity. The most effective solution in the majority of cases is probably the association of treatment of the hemorrhagic syndrome with basic estrogen therapy of the disease process.