To the Editor.—Embolization of the internal maxillary arteries as a treatment for epistaxis secondary to Rendu-Osler-Weber disease as advocated by Drs Strother and Newton (Archives 102:58-60, 1976) is an interesting concept. I believe, however, that further follow-up on this patient is indicated prior to the widespread acceptance of this therapeutic modality.
I was privileged to treat this man after his embolization and I think it is important to place this in perspective. The patient's second episode of epistaxis was initially controlled by ligation of an arterial bleeder, but the period of hospitalization was ten days and the patient was discharged with salt pork packing still in his nose. I initially saw the patient 11 days following this, and he gave a history of bleeding small amounts daily, which he controlled with self-packing. His hematocrit reading was 26% (it was 40% when discharged 11 days earlier) and he was given