Medico-economic Evaluation of Management Strategies for Severe Epistaxis
University Hospital, Toulouse
180 participants
May 1, 2023
INTERVENTIONAL
Conditions
Summary
Current recommendations consider surgical ligation and supra-selective embolization as equivalent in terms of efficacy and there is no clear consensus to choose between one and the other technique. In the absence of medico-economic studies, these recommendations could not be based on any differences in efficiency between the two techniques. The management of patients with severe non-traumatic epistaxis remains controversial and varies according to the hospital and/or university centers. In practice, the use of one or the other technique depends on the habits of each reference center.
Eligibility
Inclusion Criteria5
- Patient with severe epistaxis who failed treatment with double tamponade for more than 48 hours.
- Patient over 18 years old
- Affiliated patient or beneficiary of a social security scheme.
- Patient accepting the principle of randomization
- Free, informed and written consent, signed by the participant and the investigator (at the latest on the day of inclusion and before any examination required by the research).
Exclusion Criteria12
- Patient with epistaxis secondary to facial and/or surgical trauma.
- Patient with epistaxis related to a malignant tumor cause
- Patient with a history of ligation or embolization
- Patient under legal protection and/or curatorship and/or guardianship.
- Impossibility of giving the person informed information and ensuring the subject's compliance due to impaired physical and/or psychological health.
- Patient participating in another research including an exclusion period still in progress
- Pregnant or breastfeeding patient
- For non randomized patient
- Patient with a contraindication to general anesthesia: severe and/or decompensated cardiac/hepatic/renal insufficiency, ASA score 4
- Severe hemostasis disorders that cannot benefit from correction.
- History of transient and/or definitive stroke of the ischemic type
- Atheromatous overload
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Interventions
the surgical ligation of one or both sphenopalatine arteries by endoscopic way.
occlusion of the terminal branches of the nasal external carotid artery.
Locations(1)
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NCT05281952