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 (at the latest on the day of inclusion and before any examination required by the research). 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's compliance due to impaired physical and/or psychological health. * Patient participating in another research including an exclusion period still in progress * Pregnant or breastfeeding patient For non randomized patient * Patient with a contraindication to general anesthesia: severe and/or decompensated cardiac/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