Abstract:

Objective

To investigate the clinical efficiency of Glubran-2 in the selective arterial embolization treatment of refractory nasal bleeding in patients with nasopharyngeal carcinoma.

Methods

A retrospective analysis was conducted on the clinical data of 56 patients with refractory nasal bleeding due to nasopharyngeal carcinoma， who underwent Glubran-2 embolization in the neurosurgery department of the Third Affiliated Hospital of Southern Medical University from July 2018 to December 2023.Based on angiographic results. the patients were divided into a pseudoaneurysm group （29 cases） and a nonpseudoaneurysm group（27 cases）.The pseudoaneurysm group received super-selective embolization ， while the non-pseudoaneurysm group underwent empiric embolization of feeding arteries. Differences in clinical characteristics and prognosis between the two groups were analyzed.

Results

There was a statistically significant difference in the amount of bleeding between the two groups （P=0.029）. A total of 52 patients（92.9%） achieved completely hemostasis， 100% （29/29） in the pseudoaneurysm group and 85.2% （23/27） in the non-pseudoaneurysm group. Thirteen patients （23.2%） experienced complications， with 3 cases （10.3%）in the pseudoaneurysm group and 10 cases （37.0%） in the non-pseudoaneurysm group. The difference was statistically significant （P=0.018）.

Conclusion

In patients with nasopharyngeal carcinoma， rupture of pseudoaneurysms from the external carotid artery is more likely to result in severe bleeding. Both Glubran-2 super-selective embolization and empirical embolization are effective hemostatic methods. Super selective embolization of pseudoaneurysm is safer than empirical selective embolization.

Key words: Nasopharyngeal cancer, Pseudoaneurysm of the external carotid artery, Intractable epistaxis, Superselective arterial embolization, Glubran-2