34. Preliminary outcomes of hemorrhoidal artery embolization in the treatment of hemorrhoidal disease
Main Article Content
Abstract
The study aims to describe the technique and evaluate the preliminary outcomes of hemorrhoid treatment using embolization, through a prospective, descriptive study with pre- and post-intervention comparisons. Results were analyzed based on the degree of hemorrhoidal prolapse (Goligher classification), bleeding severity (French Bleeding Score - FBS), and quality of life (QoL scale, 0-4). After 3 months, 10/13 patients exhibited reduced hemorrhoid grade (predominantly to grade I), 6/8 patients ceased bleeding, and quality of life improved significantly, with QoL scores decreasing from 3 ± 0.58 to 0.77 ± 0.3. One case required re-embolization due to recurrent bleeding, while another one involved adjunctive endoscopic rubber band ligation. Minor complications, including tenesmus, constipation, and pain at the femoral puncture site, typically resolved within 1 - 3 weeks; two cases of rectal ulceration secondary to ischemia were stabilized following medical management. Preliminary hemorrhoidal artery embolization demonstrates efficacy in symptom reduction and enhancement of quality of life in patients with hemorrhoids.
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Keywords
Hemorrhoidal artery embolization, emborrhoid technique, treatment of hemorrhoids by embolization
References
2. Morinaga K, Hasuda K, Ikeda T. A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol. 1995;90(4). Accessed July 26, 2025. https://pubmed.ncbi.nlm.nih.gov/7717320/.
3. Vidal V, Louis G, Bartoli JM, Sielezneff I. Embolization of the hemorrhoidal arteries (the emborrhoid technique): A new concept and challenge for interventional radiology. Diagn Interv Imaging. 2014; 95(3): 307-315. doi:10.1016/j.diii.2014.01.016.
4. Buso Gil S, Ferrer Puchol MD, Solaz Solaz J, Esteban Hernández E. Prevalent Technique and Results of Hemorrhoidal Embolization. J Clin Med. 2022; 11(22): 6631. doi:10.3390/jcm11226631.
5. Stecca T, Farneti F, Balestriero G, et al. Superior Rectal Artery Embolization for Symptomatic Grades 2 and 3 Hemorrhoidal Disease: 6-Month Follow-up among 43 Patients. J Vasc Interv Radiol. 2021; 32(9): 1348-1357. doi:10.1016/j.jvir.2021.06.005.
6. Thomson WHF. The nature of haemorrhoids. BJS Br J Surg. 1975; 62(7): 542-552. doi:10.1002/bjs.1800620710.
7. Panneau J, Mege D, Di Bisceglie M, et al. Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques. RadioGraphics. 2022; 42(6): 1829-1844. doi:10.1148/rg.220014.
8. Moussa N, Sielezneff I, Sapoval M, et al. Embolization of the superior rectal arteries for chronic bleeding due to haemorrhoidal disease. Colorectal Dis. 2017; 19(2): 194-199. doi:10.1111/codi.13430.
9. de Oliveira DS, Hora JAB, de Assis AM, Moreira AM, Nahas SC, Carnevale FC. Embolization of Rectal Arteries for Treating Hemorrhoidal Disease Using a Combination of Microspheres and Microcoils: A Pilot Study. Cardiovasc Intervent Radiol. 2025; 48(3): 388-394. doi:10.1007/s00270-024-03942-3.
10. Bagla S, Pavidapha A, Lerner J, et al. Outcomes of Hemorrhoidal Artery Embolization from a Multidisciplinary Outpatient Interventional Center. J Vasc Interv Radiol JVIR. 2023; 34(5): 745-749. doi:10.1016/j.jvir.2023.01.023.
11. Tradi F, Louis G, Giorgi R, et al. Embolization of the Superior Rectal Arteries for Hemorrhoidal Disease: Prospective Results in 25 Patients. J Vasc Interv Radiol. 2018; 29(6): 884-892.e1. doi:10.1016/j.jvir.2018.01.778.
12. Lupattelli T. Regarding “Annoyed with Hemorrhoids? Risks of the Emborrhoid Technique.” Dig Dis Sci. 2022; 67(4): 1423-1425. doi:10.1007/s10620-021-07374-8.