Medico-economic Evaluation of Management Strategies for Severe Epistaxis

Inclusion Criteria:

• Patient with severe epistaxis who failed treatment with double tamponade for more than 48 hours.
• Patient over 18 years old
• Affiliated patient or beneficiary of a social security scheme.
• Patient accepting the principle of randomization
• Free, informed and written consent, signed by the participant and the investigator (atthe latest on the day of inclusion and before any examination required by theresearch).

Exclusion Criteria:

• Patient with epistaxis secondary to facial and/or surgical trauma.
• Patient with epistaxis related to a malignant tumor cause
• Patient with a history of ligation or embolization
• Patient under legal protection and/or curatorship and/or guardianship.
• Impossibility of giving the person informed information and ensuring the subject'scompliance due to impaired physical and/or psychological health.
• Patient participating in another research including an exclusion period still inprogress
• Pregnant or breastfeeding patient For non randomized patient
• Patient with a contraindication to general anesthesia: severe and/or decompensatedcardiac/hepatic/renal insufficiency, ASA score 4
• Severe hemostasis disorders that cannot benefit from correction.
• History of transient and/or definitive stroke of the ischemic type
• Atheromatous overload