Vascular Interventions in Head and Neck

Endovascular embolization techniques and minimally invasive procedures have revolutionized the management of various head and neck conditions, including intractable epistaxis and vascular malformations, as well as palliative care for advanced malignancies. Liquid agents such as glue and Onyx provide effective embolization by flowing distally into complex vessels, with minimal reliance on the patient’s coagulation profile, although they pose risks like catheter blockage and tumour bed embolization. Coils and vascular plugs offer precise deployment in high-flow vessels but come with challenges such as dislodgement and high costs. In the context of epistaxis, particulate embolization has become the preferred method for controlling posterior nasal bleeding that resists conventional treatments. Techniques such as pre-embolization angiography help identify the source of bleeding and minimize risks, with gelatin sponge, polyvinyl alcohol particles, and platinum coils being commonly used agents. Although minor complications are frequent, serious outcomes, including facial nerve paralysis or blindness, are rare. In head and neck oncology, radiofrequency ablation (RFA) offers a promising palliative treatment for advanced malignancies, improving quality of life by providing pain relief and tumour reduction with minimal complications.