Twenty-eight retrospective case series (n=736) were included. Of these, 15 studies evaluated ligation of the IMAXA (n=472) and 13 studies evaluated ligation of the SA (n=264).
None of the studies reported inclusion and exclusion criteria, the number of patients eligible for surgery, or losses to follow-up.
Ligation of the IMAXA.
Seven studies (n=145) reported no re-bleeding within 30 days; 8 studies reported re-bleeding rates ranging from 6 to 27%. The rates of re-bleeding within 1 year ranged from 0 to 44% (based on 8 studies).
The duration of post-operative hospital stay ranged from 2 to 11 days (based on 10 studies).
Complication rates varied widely (range: 2 to 85%). The most commonly reported complications were temporary facial swelling, eccymosis and persisting facial numbness.
Ligation of the SA.
Three studies (n=28) reported no re-bleeding within 30 days; 10 studies reported re-bleeding rates ranging from 3 to 30%. The rates of rebleeding within one year ranged from 0 to 30% (based on 10 studies).
The duration of post-operative hospital stay was between 1 and 3 days in 6 studies, and was 9 and 13 days in a further 2 studies.
Complication rates varied widely: 6 studies reported no post-operative complications, whilst 3 studies reported rates of 7%, 16% and 53%, respectively. The most commonly reported complications were crust formation, sensation of dryness in the nose and persistent posterior rhinorrhoea.
None of the studies directly compared ligation of the IMAXA with ligation of the SA.