SIR 2024
Gastrointestinal Interventions
Abin Sajan, MD
Resident
Columbia Irving Medical Center
Financial relationships: Full list of relationships is listed on the CME information page.
Jade Lerner, MD (she/her/hers)
Resident
Rutgers New Jersey Medical School
Financial relationships: Full list of relationships is listed on the CME information page.
Alex Pavidapha, MD
Vascular & Interventional Radiologist
Prostate Centers USA
Disclosure information not submitted.
Ari Isaacson, MD, FSIR
Interventional Radiologist; Chair of Quality & Research
Prostate Centers USA
Disclosure information not submitted.
Rachel Piechowiak, MD
Vascular & Interventional Radiologist
Prostate Centers USA
Disclosure information not submitted.
Sandeep Bagla, MD
President
IR Centers, Prostate, Hemorrhoid & Ortho Centers Network
Disclosure information not submitted.
To evaluate the long-term efficacy of hemorrhoid artery embolization (HAE) in patients with symptomatic hemorrhoids.
Materials and Methods:
221 patients with symptomatic bleeding internal hemorrhoids refractory to prior treatment were treated with HAE between August 2021 and April 2023 (115 males and 106 females). The average age was 57.1 years with an average Goligher's hemorrhoid grade (HG) of 2.1. After undergoing embolization of the abnormal vascular blush at the hemorrhoidal cushion, patients were evaluated at baseline, 1-, 3-, and 6-12 months for the following standardized outcomes: 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).
Results:
Technical success was achieved in 221/221 patients (100%). Clinical success was seen in 90% (200/221) of patients at 1-month post-procedural follow-up with 21 patients requiring repeat embolization. Significant improvements were demonstrated for all measures outcomes at 1-, 3-, and 6-12 month. The 6–12-month outcomes were: HSS (10.8 to 8.0, p < 0.01), HRP (3.8 to 1.2, p < 0.01), QoL (2.1 to 1.1, p < 0.01), FBS (4.2 to 2.3, p < 0.01), and HG (2.8 to 2.5, p < 0.05). 4 adverse events were reported and resolved by 30 days post-procedure. 18 out of 21 treatment failures were associated with a dominant middle rectal artery supply.
Conclusion:
Hemorrhoidal artery embolization is ab effective long-term outpatient treatment option for refractory symptomatic internal hemorrhoids.