Transarterial embolization is the gold standard for managing severe, refractory epistaxis, especially when a specific bleeding vessel or pseudoaneurysm is identified. It involves selectively catheterizing the bleeding artery (e.g., sphenopalatine artery, internal maxillary artery branches) and occluding it with embolic agents. Percutaneous transluminal angioplasty and stent placement are procedures primarily used for treating arterial stenoses or dissections. Inferior vena cava filter placement is indicated for preventing pulmonary embolism in patients with deep vein thrombosis.
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