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

Vidal, Vincent; Sapoval, Marc; Sielezneff, Y.; Parades, Vincent de; Tradi, Farouk; Louis, Guillaume; Bartoli, Jean Michel; Pellerin, Olivier

doi:10.1007/s00270-014-1017-8

Cited by 54 publications

(49 citation statements)

References 23 publications

(32 reference statements)

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“…And presumed that possible complications could be related to the femoral puncture and to a potential rectal ischemia and suggested that using coils which lead to a non-distal embolization limits the risk of ischemia. Also there was found that patients who previously had rectal surgeries had more developed vascular network of the rectum with more anastomoses [7]. Another retrospective study with 30 patients reported the clinical success of the emborrhoid technique in 72% of patients, with no complications observed.…”

Section: Discussionmentioning

confidence: 86%

Hemoroidinių arterijų embolizacija – naujas hemorojaus gydymo metodas: atvejo pristatymas

Zaks¹,

Mažrimas²,

Poškus³

et al. 2017

LietChirur

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Background / ObjectiveHemorrhoids are a very common anorectal condition, affecting millions of people around the world and represent major medical and socioeconomic problem. New technique for treating symptomatic hemorrhoids has been introduced in to clinical practice. Only limited number of cases using this technique were reported. This was a first clinical case in Lithuania using this technique for treating hemorrhoids. 44 year-old-man underwent liver transplantation for B viral cirrhosis in 2011. He developed liver transplant cirrhosis, hepatorenal syndrome, portal hypertension, hiperuricaemia. He presented to us with recurrent episodes of massive rectal bleeding, requiring multiple transfusions, with hemoglobin as low as 45 g/l. Several episodes of conservative treatment for hemorrhoids was not effective. Because of thrombocytopenia, risk of intra-and postoperative bleeding usual choice of surgical or minimally invasive treatment for hemorrhoids was not possible. The choice of selective angiography and embolization was made. On the 30th of July 2015 the patient underwent visceral and selective mesenteric angiograms. Inferior mesenteric artery was canulated. Terminal branches of the inferior rectal artery were embolized using Interblock 18 microspirals. Three spirals were used. Rectal bleeding stopped. Proctoscopy was performed after three weeks. Hemorrhoidal cushions were reduced by approximately 70%. No recurrent bleeding was observed 23 months after the procedure. The patient safely underwent repeated liver transplantation within 1 month. Conclusions Embolization of inferior rectal arteries requires multidisciplinary approach. Emborrhoid is a safe, effective microinvasive treatment for hemorrhoids in patients, who are otherwise at high risk for surgical complications. Key words: hemorrhoidal disease, embolization, superior rectal artery, emborrhoid 121Emborrhoid -a new treatment method for hemorrhoids: case presentation Įvadas / tikslas Keturiasdešimt ketverių metų vyrui dėl lėtinio hepatito B išsivysčiusios kepenų cirozės 2011 m. rugsėjo 30 d. atlikta kepenų transplantacija. Progresuojant hepatitui po 4 metų išsivystė kepenų transplantato cirozė, hepatorenalinis sindromas, portinės hipertenzijos sindromas (splenomegalija ir hipersplenizmas, stemplės venų varikozė, tiesiosios žarnos venų varikozė), hiperurikemija. III° hemorojus komplikavosi gausiais kraujavimais. Dėl posthemoraginės anemijos kelis kartus atliktos hemotransfuzijos. Konservatyvus gydymas buvo neveiksmingas. Dėl trombocitopenijos (45x10⁹/l), tiesiosios žarnos venų varikozės, gausaus kraujavimo operacijos metu arba po operacijos didelio pavojaus klasikinės hemoroidektomijos arba mikroinvazinių operacijų (LHP, THD) nebuvo galima atlikti. Situacija buvo aptarta konsiliume dalyvaujant intervenciniams radiologams. Buvo nuspręsta atlikti hemoroidinių arterijų embolizaciją. 2015 m. liepos 30 d. buvo atliktos visceralinė ir selektyvi angiografija. Į apatinę mezenterinę arteriją buvo įvesta kaniulė. Hemoroidinių arterijų embolizacija atlikta "Interbl...

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Section: Discussionmentioning

confidence: 86%

Hemoroidinių arterijų embolizacija – naujas hemorojaus gydymo metodas: atvejo pristatymas

Zaks¹,

Mažrimas²,

Poškus³

et al. 2017

LietChirur

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“…Vidal et al [25] reported a new concept for the treatment of hemorrhoids with arterial embolization. Fourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique.…”

Section: Discussionmentioning

confidence: 99%

Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study

Miyamoto¹,

Hada²,

Ishiyama³

et al. 2016

WJH

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AIM:To show that aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy has a high success rate for Grade Ⅱ and Ⅲ hemorrhoids. METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades Ⅱ and Ⅲ hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy. RESULTS:One hundred and sixty-nine patients were diagnosed with Grade Ⅱ hemorrhoids and 435 patients were diagnosed with Grade Ⅲ hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades Ⅱ and Ⅲ hemo- Retrospective Study 845July 18, 2016|Volume 8|Issue 20| WJH|www.wjgnet.com Miyamoto H et al . ALTA sclerotherapy for Grade Ⅱ and Ⅲ hemorrhoids rrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades Ⅱ and Ⅲ hemorrhoids (P = 0.09). There were forty-seven post-operative complications (low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure. CONCLUSION:ALTA sclerotherapy has had a high success rate for Grade Ⅱ and Ⅲ hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.

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“…I recently read with great interest the article by Vidal et al The authors treated hemorrhoids with coil embolization of terminal branches of the superior rectal arteries in 14 patients with promising results [1].…”

mentioning

confidence: 99%

Arterial Embolization of Hemorrhoids

Таразов

2015

Cardiovasc Intervent Radiol

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

Abstract: 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.

Cited by 54 publications

References 23 publications

Hemoroidinių arterijų embolizacija – naujas hemorojaus gydymo metodas: atvejo pristatymas

Hemoroidinių arterijų embolizacija – naujas hemorojaus gydymo metodas: atvejo pristatymas

Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study

Arterial Embolization of Hemorrhoids

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