Tessler I, Warman M, Shimrit S, et al. - Researchers here examined if and how endoscopic sphenopalatine artery ligation (ESPAL) integration affects persistent epistaxis management over 15 years in a single academic center. In this retrospective study, they divided the study population based on admission year, prior to 2011 (pre-ESPAL) and from 2011 till the end of data collection (post-ESPAL); the pre-ESPAL group included 87 interventions and the post-ESPAL group 54 interventions. In this study, a shifting trend has been identified in management of persistent epistaxis with successful replacement of posterior nasal packing by ESPAL. In lieu of these findings, clinicians may consider ESPAL as a useful tool in the management of persistent epistaxis.