SRAE With Embospheres for Hemorrhoids.

Superior Rectal Artery Embolization With Tri-acryl Gelatin Particles for Treatment of Symptomatic Hemorrhoids: Safety and Efficacy

In this study , safety and efficacy of superior rectal artery embolization with embospheres will be researched prospectively.

Symptomatic hemorrhoidal disease is a still important public health problem although there are many surgical and nonsurgical minimal invasive treatment methods. Treatment methods are not satisfactory or invasive in some percent of the patients. Superior rectal artery embolization(SRAE) for hemorrhoids is an adapted technique derived from Doppler-guided hemorrhoidal artery ligation (DGHAL). In this technique, the distal branches of the superior rectal artery arising from the inferior mesenteric artery is occluded endovascularly with coils. Its feasibility and safety were supported by articles. Collateralization and recurrence was seen following coil embolization. To prevent this , tri-acryl gelatin microspheres in 500-700 and 700-900 micrometers in size will be used. Safety and efficacy of embolization and using different sized particles will be evaluated.

Inclusion Criteria:

• Patients with symptoms of hemorrhoidal disease
• Patients with written informed consent
• Patients refusing surgery or other interventional methods
• Patients with high risk for surgery
• Patients accepting follow ups

Exclusion Criteria:

• Previous intervention
• Colorectal diseases other than hemorrhoids
• Patients with anal stenosis
• Patients with rectal prolapsus
• pregnant patients
• Patients with contraindications for technical steps or contrast usage.
• Patients do nor or could not give written informed consent