At LINNC Paris 2024, Dr. Rabih Tawk presents a complex case involving the multifaceted management of recurrent, severe epistaxis tied to an internal carotid artery pseudoaneurysm and bilateral carotid occlusion. The 56-year-old patient, with a history of Cushing’s disease and prior treatments including transnasal resection and Gamma Knife therapy, experienced escalating epistaxis episodes despite multiple interventions. Following a recent B/L IMAX embolization, severe nasal bleeding occured, requiring transfusions and posing a significant clinical challenge. Watch the video to learn how Dr. Tawk’s team addressed this high-risk case!