{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:15:07Z","timestamp":1791656107136,"version":"4.3.4"},"reference-count":30,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2014,5,2]]},"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Intractable hemorrhage of the nasal or oropharyngeal cavities can be life threatening, and endovascular embolization is one of the few effective treatments for severe recurrent bleeds. Traditionally, embolic particles have been used for transarterial embolization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the safety and efficacy of a less commonly performed treatment\u2014namely, feeding artery occlusion with liquid embolic agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed our neurointerventional database for patients who had undergone transarterial embolization for intractable nasal and oropharyngeal hemorrhage with Onyx, N-butyl-2 cyanoacrylate (n-BCA) glue, or both, at our institution over a 5-year period from 2008 to 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty-six patients who underwent a total of 51 procedures met the inclusion criteria. Causes of hemorrhage included neoplasm n=35 (68.6%), trauma n=12 (23.5%), and idiopathic n=4 (7.9%). The bleeding was oropharyngeal in 66.7%, nasal in 29.4%, and 3.9% originated from both sites. Embolic agents used were n-BCA in 26 cases (51.0%), Onyx in 22 cases (43.1%), and both agents in three cases (5.9%). Mean total procedural time was 93.1\u2005min (range 34\u2013323\u2005min), and mean fluoroscopy time was 39.1\u2005min (10\u2013 121\u2005min). Mean follow-up time was 7.4\u2005months (0.25\u201336\u2005months). Five of the 46 patients (10.9%) required re-embolization and one (2.0%) rebled during the same hospital stay. One periprocedural cardiovascular adverse event occurred that was unrelated to the embolic agent used, but no other complications were seen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transarterial embolization with n-BCA or Onyx is a safe and effective treatment for patients with intractable nasal and oropharyngeal hemorrhage. Further prospective studies are warranted to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2014-011101","type":"journal-article","created":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T03:11:31Z","timestamp":1401160291000},"page":"537-541","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Transarterial embolization of intractable nasal and oropharyngeal hemorrhage using liquid embolic agents"],"prefix":"10.1136","volume":"7","author":[{"given":"Seth B","family":"Hayes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah N","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Most","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Samy","family":"Elhammady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dileep","family":"Yavagal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ali","family":"Aziz-Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,5,26]]},"reference":[{"key":"2024052301040050000_7.7.537.1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1017\/S0022215111003148","article-title":"The role of embolisation in ENT: an update","volume":"126","author":"Risley","year":"2012","journal-title":"J Laryngol Otol"},{"key":"2024052301040050000_7.7.537.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000247301.64269.27"},{"key":"2024052301040050000_7.7.537.3","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2212001140"},{"key":"2024052301040050000_7.7.537.4","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000220215.71485.07"},{"key":"2024052301040050000_7.7.537.5","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000333292.74986.ac"},{"key":"2024052301040050000_7.7.537.6","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.3171\/2009.7.JNS09351","article-title":"Safety and efficacy of vascular tumor embolization using Onyx: is angiographic devascularization sufficient?","volume":"112","author":"Elhammady","year":"2010","journal-title":"J Neurosurg"},{"key":"2024052301040050000_7.7.537.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.09.031"},{"key":"2024052301040050000_7.7.537.8","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1007\/s00270-004-0130-5","article-title":"Endovascular therapy for management of oral hemorrhage in malignant head and neck tumors","volume":"28","author":"Kakizawa","year":"2005","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2024052301040050000_7.7.537.9","first-page":"485","article-title":"Evaluation of particulate embolic materials with MR imaging, scanning electron microscopy, and phase-contrast microscopy","volume":"18","author":"Nakabayashi","year":"1997","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052301040050000_7.7.537.10","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/01.RVI.0000052296.26939.4c","article-title":"Pathologic evaluation of a spherical polyvinyl alcohol embolic agent in a porcine renal model","volume":"14","author":"Siskin","year":"2003","journal-title":"J Vasc Interv Radiol"},{"key":"2024052301040050000_7.7.537.11","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1085930"},{"key":"2024052301040050000_7.7.537.12","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1055\/s-0030-1247891","article-title":"Embolization agents-which one should be used when? 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