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Br J Ophthalmol 2007;91:122-123 doi:10.1136/bjo.2006.100941
  • Letter

Iatrogenic central retinal artery occlusion during treatment for epistaxis

  1. P T Ashwin,
  2. S Mirza,
  3. N Ajithkumar,
  4. M D Tsaloumas
  1. Birmingham and Midland Eye Centre, Birmingham, UK
  1. Correspondence to: Mr P T Ashwin Birmingham and Midland Eye Centre, Dudley Road, Birmingham B18 7QH, UK; pammal.ashwin{at}gmail.com
  • Accepted 16 June 2006

Maxillary artery embolisation with polyvinyl alcohol (PVA) is a procedure used for the treatment of intractable epistaxis. We report a rare but devastating complication of this otherwise safe and successful procedure.

Case report

A 46-year-old man presented to the accident and emergency department with a 1-day history of left epistaxis. He had had mild infrequent episodes in the past. He had cauterisation of the Little’s area, but as the bleeding persisted, nasal packing was performed and blood tests were done. The platelet count was 310×109/l; other tests were normal. The epistaxis persisted the next day and a new bismuth idoform paraffin paste nasal pack was inserted. He underwent a nasal endoscopy the next day and an arterial bleed in the area of the left sphenopalatine artery was observed. Electrocautery to this area was performed and a post-nasal pack was applied.

Despite these …

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