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Episode 48

Treatment of Epistaxis by IR and ENT

with Dr. Ashley Agan and Dr. Sabeen Dhand

BackTable, LLC (Producer). (2019, August 30). Ep. 48 – Treatment of Epistaxis by IR and ENT [Audio podcast]. Retrieved from

IR Sabeen Dhand and ENT Ashley Agan discuss management of Epistaxis, including how to effectively pack the nose, and when SPA ligation or arterial embolization are necessary. Dr. Dhand also describes his arterial embolization technique, including important pitfalls to avoid.

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Podcast Participants

Dr. Ashley Agan

Dr. Ashley Agan is a practicing ENT and assistant professor at UT Southwestern Medical Center in Dallas, TX.

Dr. Sabeen Dhand

Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.

Dr. Gopi Shah

Host Gopi Shah is a practicing ENT at UT Southwestern Medical Center in Dallas, TX.

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Show Notes

In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. We cover the differences in how epistaxis presents for ENT and IR as well as how epistaxis presents in children and older patients. Dr. Agan tells us about the types of nosebleeds that are common and the general treatment algorithm she follows.

We discuss nasal packing and decongestant sprays for treatment and how to know when to take the patient to the OR. Dr. Agan talks about isolating the bleeding spot, how to use a foley for posterior nosebleeds, and SPA litigation. We discuss why ENT might consult IR for an embolization.

Dr. Dhand tells us about the contraindications for embolization and the procedure for treating the epistaxis. We review the materials that should be used and why it is important to look out for artery connections and pseudoaneurysms. We discuss the pearls and pitfalls of ENT and IR treatment of epistaxis and how to avoid the risk of stroke.

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