| Institution: | 1. Hemorrhoid Centers USA, Falls Church, Virginia;2. St. George’s University, Great River, New York;3. Prostate Centers USA, Reston, Virginia;4. Gastro Health, Woodbridge, Virginia;5. Prostate Centers USA, Raleigh, North Carolina;6. Department of Radiology (A.S.), Columbia University Irving Medical Center, New York, New York;1. St George’s University School of Medicine, Grenada, West Indies;2. Prostate Centers USA, Falls Church, VA;1. Larner College of Medicine at the University of Vermont, University of Vermont, Burlington, Vermont;2. University of Vermont Medical Center, Burlington, Vermont;1. Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois;2. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, Illinois;3. Hematology and Oncology, Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, Illinois;4. Transplantation Institute, Department of Surgery, University of Chicago Medical Center, University of Chicago, Chicago, Illinois;5. Division of Transplantation and Advanced Hepatobiliary Surgery, University of Utah, Salt Lake City, Utah |
| Abstract: | PurposeTo evaluate the safety and efficacy of outpatient transarterial embolization for symptomatic refractory internal hemorrhoids.Materials and MethodsRetrospective analysis of 134 patients who underwent hemorrhoidal artery embolization (HAE) for symptomatic internal hemorrhoids between August 2021 and June 2022 (76 men and 58 women) was performed. The mean age was 54.9 years, with a mean Goligher hemorrhoid grade (HG) of 2.1. Branches of the superior rectal artery (SRA) or middle rectal artery supplying the corpus cavernosum recti were embolized with both spherical particles and microcoils. Standard-of-care evaluations were performed at baseline and the 1 month follow-up, which included hemorrhoid-related pain (HRP) (0–10), hemorrhoid symptoms score (HSS) (5–20), quality of life (QoL) (0–4), French bleeding score (FBS) (0–9), and HG (0–4). Clinical success was defined as improvement of symptoms without additional treatment.ResultsEmbolization of at least 1 hemorrhoidal artery was achieved in 133 (99%) of the 134 patients. The mean number of SRA branches embolized per patient was 2.9 ± 1.0. Clinical success was seen in 93% (124 of 134) of patients at the 1-month follow-up, with 10 patients requiring repeat embolization. There were significant improvements in all mean outcomes at 1 month: HSS (11–7.8; P < .01), HRP (4.1–1.3; P < .01), QoL (2.2–0.8; P < .01), FBS (4.4–2.2; P < .01), and HG (2.3–1.2; P < .05). There were no severe adverse events.ConclusionsHAE is a safe and effective outpatient treatment for refractory symptomatic internal hemorrhoids in the short term. |
