To investigate the angiographic manifestation and evaluate the safety and efficacy of transarterial embolization (TAE) for intractable epistaxis.

From January 2009 to September 2017, the clinical data of 59 patients with intractable bleeding undergoing TAE in our department were reviewed. All cases were divided into 40 cases of benign group and 19 cases of malignant group. According to angiographic findings, the patients were divided into 45 cases of positive group and 14 cases of negative group. The outcomes of interventional therapy were assessed according to different causes of disease (malignant or benign disease) and angiographic finding (positive or negative angiogram) .

All the 59 patients recieved diagnostic angiography. Bleeding was controlled successfully in 58 patients after embolization except 1 patient who died of rupture of ICA pseudoaneurysm. Positive angiographic findings were found in 29 of 40 cases (72.5%) with benign diseases and 16 of 19 cases (84.2%) with malignant diseases, respectively, there was no significant difference between them (χ²=0.436, P=0.509) . There was no significant difference in recurrence rates between patients with benign diseases (2/40, 5.0%) and malignant diseases (4/18, 22.2%) (P=0.068) . No significant difference was found in recurrence rates between patients with positive (4/44, 9.1%) and negative angiography (2/14, 14.3%) (P=0.624) .

TAE appears to be a safe and effective treatment for patients with intractable epistaxis. For patients with negative angiographic finding, bilateral IMA embolization is an effective method.