To provide a comprehensive overview of posterior epistaxis, focusing on its vascular anatomy and the role of endovascular treatment, emphasizing its impact on treatment outcomes.
Approach:
Key Findings:
Posterior epistaxis is challenging due to variable etiologies and complex vascular anatomy.
Endovascular treatment is feasible and safe, requiring thorough angiographic assessment prior to intervention.
Current guidelines still classify endovascular therapy as a last-resort option, which may hinder timely intervention.
Interpretation:
Endovascular therapy should be reconsidered as a viable option for posterior epistaxis rather than being reserved for intractable cases, given its effectiveness and safety profile supported by recent studies.
Limitations:
The review is based on existing literature, which may have inherent biases.
Variability in clinical practice and guidelines may affect the generalizability of findings, and publication bias may influence the perceived effectiveness of treatments.
Conclusion:
A comprehensive approach, including angiography, can enhance treatment outcomes for posterior epistaxis, and endovascular therapy should be more widely accepted as a primary treatment option, necessitating a shift in clinical guidelines.
by Hector R. Martinez, Daniel F. Aguilera-Maldonado, Andrea Paola Sanchez-Cantu, Patricia Maria Orviz-Ortiz, Oscar I. Paz-Sanchez, Nerea Martin del Campo, Carlos Cuilty-Siller, Karla Santos-Santillan, Jorge Arechavaleta Santos, Oscar Gutierrez Trevino, Beatriz Elena Perez-Martinez, Jose A. Figueroa-Sanchez
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