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CardioVascular and Interventional Radiology

, Volume 38, Issue 1, pp 72–78 | Cite as

Emborrhoid: A New Concept for the Treatment of Hemorrhoids with Arterial Embolization: The First 14 Cases

  • V. Vidal
  • M. Sapoval
  • Y. Sielezneff
  • V. De Parades
  • F. Tradi
  • G. Louis
  • J. M. Bartoli
  • O. Pellerin
Clinical Investigation

Abstract

Purpose

The ‘emborrhoid’ technique consists of the embolization of the hemorrhoidal arteries. The endovascular arterial occlusion is performed using coils placed in the terminal branches of the superior rectal arteries. The emborrhoid technique has been modeled after elective transanal Doppler-guided hemorrhoidal artery ligation which has been shown to be effective in hemorrhoidal disease. We report the first 14 cases of our experience with emborrhoid technique.

Materials and Methods

Fourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique (3 women, 11 men). The stage of the hemorrhoidal disease was II (10 patients), III (3), and IV (1). This treatment was decided by a multidisciplinary team (proctologist, visceral surgeon, and radiologist). Seven patients underwent previous proctological surgery. Ten patients had coagulation disorders (anticoagulants or cirrhosis). Superior rectal arteries were embolized with pushable microcoils (0.018).

Results

Technical success of the embolization procedure was 100 %. Clinical success at 1 month was 72 % (10/14). Of the 4 patients who experienced rebleeding, two underwent additional embolization of the posterior rectal arteries with success. No pain or ischemic complications were observed in 13 patients. One patient experienced a temporary painful and edematous, perianal reaction.

Conclusion

Our case studies suggest that coil embolization of the superior rectal arteries is technically feasible, safe and well tolerated. Additional studies are needed to evaluate the efficacy of this new ‘emborrhoid’ technique in the management of hemorrhoidal disease.

Keywords

Embolization Hemorrhoids Inferior mesenteric artery 

List of abbreviations

DG-HAL

Elective Doppler-guided hemorrhoidal artery ligation

SRA

Superior rectal artery

Notes

Conflict of Interest

Vidal V, Sapoval M, Sielezneff Y, De Parades V, Tradi F, Louis G, Bartoli JM, and Pellerin O declare that they have no conflicts of interest related to this paper.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2014

Authors and Affiliations

  • V. Vidal
    • 1
  • M. Sapoval
    • 2
  • Y. Sielezneff
    • 3
  • V. De Parades
    • 4
  • F. Tradi
    • 1
  • G. Louis
    • 1
  • J. M. Bartoli
    • 1
  • O. Pellerin
    • 2
  1. 1.Department of RadiologyHôpital de la TimoneMarseille, Cedex 05France
  2. 2.Department of RadiologyHopital Européen Georges PompidouParisFrance
  3. 3.Department of Digestive and General SurgeryHôpital de la TimoneMarseille, Cedex 05France
  4. 4.Department of ProctologyHopital Saint JosephParisFrance

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