Transanal eco-Doppler evaluation after hemorrhoidal artery embolization

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Gastroenterology

Background:

• Hemorrhoidal artery embolization (Emborrhoid) is an emerging treatment for severe hemorrhoidal bleeding.
• While technically successful, clinical outcomes and rebleeding rates vary, necessitating further evaluation.

Purpose of the Study:

• To assess the efficacy of Emborrhoid in decreasing hemorrhoidal arterial blood flow.
• To investigate the relationship between reduced flow and improvements in hemorrhoidal bleeding scores.

Main Methods:

• A prospective observational pilot study involving 11 patients with severe hemorrhoidal bleeding.
• Pre- and post-procedure endoanal ultrasound with eco-Doppler to measure mean systolic peak (MSP) in hemorrhoidal arteries.
• Correlation analysis between changes in MSP and hemorrhoidal bleeding scores (HBS).

Main Results:

• Emborrhoid significantly reduced overall MSP (P=0.008).
• A weak correlation was observed between MSP changes and HBS (P=0.570).
• Distal embolization showed a statistical difference compared to proximal (P=0.047), and SRA anatomy influenced MSP changes (P=0.040), but neither predicted symptom improvement.

Conclusions:

• Emborrhoid effectively reduces arterial hemorrhoidal flow in patients with hemorrhoidal disease.
• The correlation between post-procedure flow reduction and symptom improvement was weak.
• Hemorrhoidal grade, SRA anatomy, and embolization type did not correlate with treatment outcomes in this pilot study.