Selective intra-arterial embolization to treat hemorrhoids

Abstract

Objective: To present our results and describe the technique used for the endovascular treatment of hemorrhoids.

Material and methods: We used right femoral artery or radial artery access to catheterize the inferior mesenteric artery, proceeding to the superior rectal artery with a 2.7F microcatheter to catheterize and embolize each distal branch distally with PVA particles (300-500μm) and proximally with coils (2-3mm). Patients were discharged 24hours after the procedure and clinically followed up at one month by anoscopy.

Results: We included 20 patients (4 women and 16 men; mean age, 61.85 years (27-81 years); mean follow-up, 10.6 months (28-2 months). Technical success was achieved in 18 (90%) patients and clinical success in 15 (83.4%); one patient required a second embolization of the medial rectal artery and two required surgery. Recovery was practically painless. At the one-month follow-up, all patients were very satisfied and anoscopy demonstrated marked improvement of the hemorrhoids. There were no complications secondary to embolization.

Conclusions: Our initial results suggest that selective intra-arterial embolization is a safe and painless procedure that is well tolerated because it avoids rectal trauma and patients recover immediately.

Keywords: Arteria mesentérica inferior; Embolización; Embolization; Endovascular procedures; Hemorrhoids; Hemorroides; Inferior mesenteric artery; Procedimientos endovasculares.