Editing Nosebleed (section)

===Surgery===
Ongoing bleeding despite good nasal packing is a surgical emergency and can be treated by endoscopic evaluation of the nasal cavity under general anesthesia to identify an elusive bleeding point or to directly ligate (tie off) the blood vessels supplying the nose. These blood vessels include the [[sphenopalatine artery|sphenopalatine]], anterior and posterior ethmoidal arteries. More rarely the maxillary or a branch of the external [[Common carotid artery|carotid artery]] can be ligated. The bleeding can also be stopped by intra-arterial [[embolization]] using a catheter placed in the groin and threaded up the aorta to the bleeding vessel by an [[Interventional radiology|interventional radiologist]].<ref name="NIH" /> There is no difference in outcomes between embolization and ligation as treatment options, but embolization is considerably more expensive.<ref>{{cite journal|last=Villwock|first=JA|author2=Jones, K |title=Recent trends in epistaxis management in the United States: 2008–2010.|journal=JAMA Otolaryngology–Head & Neck Surgery|date=Dec 2013|volume=139|issue=12|pages=1279–84|pmid=24136624|doi=10.1001/jamaoto.2013.5220|doi-access=}}</ref> Continued bleeding may be an indication of more serious underlying conditions.<ref name="NIH">[https://www.nlm.nih.gov/medlineplus/ency/article/003106.htm MedlinePlus Medical Encyclopedia: Nosebleed] U.S. [[National Library of Medicine]] [[Medline Plus]] service. Retrieved 2010-03-15.</ref>