Selective intra-arterial embolisation to treat haemorrhoids

Abstract

ObjectiveTo present our results and describe the technique used for the endovascular treatment of haemorrhoids. Material and methodsWe 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 embolise each distal branch distally with PVA particles (300–500μm) and proximally with coils (2–3mm). Patients were discharged 24h after the procedure and clinically followed up at one month by anoscopy. ResultsWe 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 embolisation 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 haemorrhoids. There were no complications secondary to embolisation. ConclusionsOur initial results suggest that selective intra-arterial embolisation is a safe and painless procedure that is well tolerated because it avoids rectal trauma and patients recover immediately.