Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques

Panneau, Julien; Mège, Diane; Biseglie, Mathieu Di; Duclos, Julie; Habert, Paul; Bartoli, Axel; Vidal, Vincent; Tradi, Farouk

doi:10.1148/rg.220014

Cited by 5 publications

(18 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Doppler-guided hemorrhoid artery ligation is performed via an anoscope with a Doppler probe that is used to localize hemorrhoidal artery branches for directed transanal suture ligation [ 8 ]. Building on the principles of hemorrhoidal dearterialization from doppler guided HAL, trans-arterial catheter-directed rectal artery embolization (RAE; “emborrhoid”) was first described by Vidal et al in 2014 as a treatment option for internal HD [ 9 , 10 ]. Over the next decade promising data have emerged on the technique, safety, and efficacy of rectal artery embolization for treatment of bleeding predominant IH [ 3 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Building on the principles of hemorrhoidal dearterialization from doppler guided HAL, trans-arterial catheter-directed rectal artery embolization (RAE; “emborrhoid”) was first described by Vidal et al in 2014 as a treatment option for internal HD [ 9 , 10 ]. Over the next decade promising data have emerged on the technique, safety, and efficacy of rectal artery embolization for treatment of bleeding predominant IH [ 3 , 9 ]. Recent meta-analyses of clinical studies have shown high technical success (98–99%) and short-term clinical efficacy to 1-year (79–82%) with clinically significant improvements in bleeding scores, quality of life and pain scores reported [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is limited information available regarding standardized protocols, study designs, or data elements. Further research and clinical trials are necessary to establish these elements, evaluate the safety and efficacy of RAE, and compare it with other available treatment options for hemorrhoidal disease [ 1 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Common design and data elements on rectal artery embolization for treatment of symptomatic internal hemorrhoidal disease: an interactive systematic review of clinical trials

Morsi,

Linares Bolsegui,

Kobeissi

et al. 2024

CVIR Endovasc

Self Cite

View full text Add to dashboard Cite

Background Internal hemorrhoids (IH) is a common medical condition that can result in morbidity secondary to bleeding and discomfort. Treatment for IH has traditionally consisted of dietary and conservative medical management, focal treatments including banding and sclerotherapy or hemorrhoidectomy. Recently, rectal artery embolization (RAE) has been studied as a potential treatment for bleeding predominant IH. We performed a common design and data element analysis of studies that report on RAE. Materials and methods We conducted a qualitative systematic literature review for rectal artery embolization (RAE) for symptomatic hemorrhoidal disease. The screening process involved five online databases (PubMed, Embase, Google Scholar, DOAJ, and Scopus). Additionally, ClinicalTrials.gov was examined for active, unpublished completed studies. The initial search yielded 2000 studies, with 15 studies meeting the inclusion criteria after screening and assessment. The included studies comprised one RCT, one case series, one pilot study and 12 cohort studies. Results The population analysis revealed a male predominance across all studies, with varying cohort sizes. The baseline Goligher hemorrhoid grade was utilized in 80% of studies. The majority (73.3%) employed a transfemoral approach, and coils were the primary embolic material in 60% of studies, 26.6% were combination of coils and particles, and 6.6% were particles only. Patient selection criteria highlighted RAE's applicability for high surgical risk patients and those with anemia, chronic hematochezia, or treatment-refractory cases. Exclusion criteria emphasized factors such as previous surgeries, colorectal cancer, rectal prolapse, acute hemorrhoidal complications, and contrast allergy. Study designs varied, with cohort studies being the most common (12/15; 80%). Procedural details included the use of metallic coils and detachable micro-coils, with a high technical success rate reported in most studies ranging from 72 to 100%. The follow-up ranged from 1 to 18 months. The majority of studies reported no major immediate or post-procedural complications. Conclusion While all studies focused on RAE as a treatment for IH, there was a great degree of heterogeneity among included studies, particularly regarding inclusion criteria, exclusion criteria, outcomes measures and timeframe. Future literature should attempt to standardize these design elements to help facilitate secondary analyses and increase understanding of RAE as a treatment option.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Common design and data elements on rectal artery embolization for treatment of symptomatic internal hemorrhoidal disease: an interactive systematic review of clinical trials

Morsi,

Linares Bolsegui,

Kobeissi

et al. 2024

CVIR Endovasc

Self Cite

View full text Add to dashboard Cite

show abstract

“…The age group with the highest incidence is between the ages of 45-65 [3]. Affecting millions of people worldwide, HD constitutes a major medical and socioeconomic issue [4]. The most common clinical picture is rectal bleeding, which causes anemia in the long term and significantly impairs the quality of life of patients.…”

Section: Introductionmentioning

confidence: 99%

“…Although the disease comes to mind when hemorrhoids are mentioned, hemorrhoids are normally found in the anus of everyone from birth, in the form of blood lakes associated with small arterial and venous vessels in the lower rectum [4]. Hemorrhoid disease is defined as distal displacement and symptomatic enlargement of these blood lakes known normal as anal cushions [5].…”

Section: Introductionmentioning

confidence: 99%

Arterial Embolization as a Prominent Option in the Treatment of Hemorrhoid Diseases

2024

Int J Prev Med Care

View full text Add to dashboard Cite

Hemorrhoidal disease (HD) is the most common anorectal disease, affecting millions of people worldwide. The most common clinical picture is rectal bleeding, which significantly impairs the quality of life of patients. Treatment of HD varies from diet and lifestyle changes to radical surgery, depending on the degree and severity of symptoms. Endovascular embolization of superior rectal artery (SRA), known as emborrhoid technique, has recently emerged as a promising minimally invasive approach. Because hemorrhoidal plexuses are almost entirely fed through the SRA. They are also fed less by middle rectal artery (MRA) and rarely inferior rectal artery (IRA). Due to some anastomoses and unpredictable variations, vascular structures must be examined before the procedure. So far, there have been reports of studies involving a small number of patients regarding the use of coils and particles as embolization agents. Some of these used particles and coils alone, while others used a combination of particles and/or coils. The studies demonstrated similar clinical efficacy with satisfactory results, and no significant complications such as ischemic necrosis were observed. The use of liquid embolic agents such as N-butyl-cyanoacrylate (NBCA) and ethylene vinyl alcohol copolymer (EVOH) has also recently been suggested to be effective. In conclusion, the current data support the feasibility, effectiveness, and safety of rectal artery embolization for hemorrhoidal disease. However, there is no guideline or consensus in the selection of embolic materials. More randomized controlled studies are needed. This review aims to evaluate the effectiveness and feasibility of embolization applications in hemorrhoidal diseases.

show abstract

Passion fruit peel fermentation extract and its active component kaempferol alleviate constipation and hemorrhoids in mice by downregulating ESR1 and PI3K/Akt pathways

Xu,

Li,

Wei

et al. 2024

Journal of Functional Foods

View full text Add to dashboard Cite

Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques

Cited by 5 publications

References 57 publications

Common design and data elements on rectal artery embolization for treatment of symptomatic internal hemorrhoidal disease: an interactive systematic review of clinical trials

Common design and data elements on rectal artery embolization for treatment of symptomatic internal hemorrhoidal disease: an interactive systematic review of clinical trials

Arterial Embolization as a Prominent Option in the Treatment of Hemorrhoid Diseases

Passion fruit peel fermentation extract and its active component kaempferol alleviate constipation and hemorrhoids in mice by downregulating ESR1 and PI3K/Akt pathways

Contact Info

Product

Resources

About