title: Endoscopic ligation of the sphenopalatine artery as a primary management of severe posterior epistaxis in patients with coagulopathy.
abstract: We describe our experience with endoscopic ligation of the sphenopalatine artery in the treatment of severe posterior epistaxis in 2 patients with coagulopathy. Conservative treatment had failed in both cases. The key elements of this procedure are the identification of the branches of the sphenopalatine artery via an endoscopic endonasal approach and the application of two titanium clips under direct vision. This procedure was successful in both patients, and we recommend it in selected cases.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, 4201 St. Antoine, UHC Suite 5E, Detroit, MI 48201, USA. ai0983@wayne.edu
authors.forename: Anand G
authors.initials: AG
authors.lastname: Shah
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stachler
authors.forename: John H
authors.initials: JH
authors.lastname: Krouse
mesh_terms: D001778:Blood Coagulation Disorders / Q000453:epidemiology*; D015897:Comorbidity; D004724:Endoscopy; D004844:Epistaxis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008026:Ligation; D008866:Microsurgery; D013101:Sphenoid Sinus / Q000098:blood supply*