title: Emborrhoid: a new concept for the treatment of hemorrhoids with arterial embolization: the first 14 cases.
abstract: OBJECTIVE
  The 'emborrhoid' technique consists of the embolization of the hemorrhoidal arteries. The endovascular arterial occlusion is performed using coils placed in the terminal branches of the superior rectal arteries. The emborrhoid technique has been modeled after elective transanal Doppler-guided hemorrhoidal artery ligation which has been shown to be effective in hemorrhoidal disease. We report the first 14 cases of our experience with emborrhoid technique.
  
  
  METHODS
  Fourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique (3 women, 11 men). The stage of the hemorrhoidal disease was II (10 patients), III (3), and IV (1). This treatment was decided by a multidisciplinary team (proctologist, visceral surgeon, and radiologist). Seven patients underwent previous proctological surgery. Ten patients had coagulation disorders (anticoagulants or cirrhosis). Superior rectal arteries were embolized with pushable microcoils (0.018).
  
  
  RESULTS
  Technical success of the embolization procedure was 100 %. Clinical success at 1 month was 72 % (10/14). Of the 4 patients who experienced rebleeding, two underwent additional embolization of the posterior rectal arteries with success. No pain or ischemic complications were observed in 13 patients. One patient experienced a temporary painful and edematous, perianal reaction.
  
  
  CONCLUSIONS
  Our case studies suggest that coil embolization of the superior rectal arteries is technically feasible, safe and well tolerated. Additional studies are needed to evaluate the efficacy of this new 'emborrhoid' technique in the management of hemorrhoidal disease.
authors.affiliation: Department of Radiology, Hôpital de la Timone, 264 rue Saint Pierre, 13385, Marseille, Cedex 05, France, vincent.vidal@ap-hm.fr.
authors.forename: V
authors.initials: V
authors.lastname: Vidal
authors.forename: M
authors.initials: M
authors.lastname: Sapoval
authors.forename: Y
authors.initials: Y
authors.lastname: Sielezneff
authors.forename: V
authors.initials: V
authors.lastname: De Parades
authors.forename: F
authors.initials: F
authors.lastname: Tradi
authors.forename: G
authors.initials: G
authors.lastname: Louis
authors.forename: J M
authors.initials: JM
authors.lastname: Bartoli
authors.forename: O
authors.initials: O
authors.lastname: Pellerin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006484:Hemorrhoids / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000000981:diagnostic imaging; D008875:Middle Aged; D012007:Rectum / Q000098:blood supply* / Q000000981:diagnostic imaging; D016896:Treatment Outcome