REGULAR CONTENT
Final ID
591
Type
Educational Exhibit-Poster Only
Authors
F Tradi1, I Sielezneff1, J Bartoli1, V Vidal1
Institutions
1Timone Hospital, Marseille, France
Purpose
- List the indications of the superior rectal arteries (SRA) embolization.- Describe the appropriate devices and tricks for the procedure.- Identify the target arteries in the corpus cavernosum recti.- Manage the anatomical variations and the anastomosis with the middle rectal arteries.
Materials & Methods
Hemorrhoid embolization (Emborrhoid) is emerging as an alternative technique to surgical treatment for chronic and disabling rectal bleeding. Symptoms are related to an increased arterial blood flow into the internal hemorrhoid cushions. The internal hemorrhoid network is known to be supplied principally by the terminal branches of the SRA, arising from the inferior mesenteric artery.First results about Emborrhoid procedure suggest that coil embolization of SRA is feasible, safe and effective.
Results
A pre-procedure clinical examination by a proctologist is very important to evaluate the stage of hemorrhoidal disease and to detect any anorectal tumor.Pre-embolization Pelvic Angio CT is useful to identify anatomical variations and atherosclerotic stenosis in order to prevent technical failure.Emborrhoid technique is performed using a femoral approach. After catheterization of the inferior mesenteric artery, the SRA are then catheterized with a microcatheter.Selective angiograms are useful to recognize the target vessels feeding the corpus cavernosum recti, and the anastomosis with the middle rectal arteries.Terminal branches of the SRA are occluded by micro-coils. The embolization should be as complete and distal as possible to restrict the reloads by middle rectal arteries.Technical success of this procedure has been reported in up to 90%.
Conclusions
Hemorrhoid embolization is technically feasible and safe.Coils placement is based on a good knowledge of the vascular anatomy of rectal arteries .
Final ID
591
Type
Educational Exhibit-Poster Only
Authors
F Tradi1, I Sielezneff1, J Bartoli1, V Vidal1
Institutions
1Timone Hospital, Marseille, France
Purpose
- List the indications of the superior rectal arteries (SRA) embolization.- Describe the appropriate devices and tricks for the procedure.- Identify the target arteries in the corpus cavernosum recti.- Manage the anatomical variations and the anastomosis with the middle rectal arteries.
Materials & Methods
Hemorrhoid embolization (Emborrhoid) is emerging as an alternative technique to surgical treatment for chronic and disabling rectal bleeding. Symptoms are related to an increased arterial blood flow into the internal hemorrhoid cushions. The internal hemorrhoid network is known to be supplied principally by the terminal branches of the SRA, arising from the inferior mesenteric artery.First results about Emborrhoid procedure suggest that coil embolization of SRA is feasible, safe and effective.
Results
A pre-procedure clinical examination by a proctologist is very important to evaluate the stage of hemorrhoidal disease and to detect any anorectal tumor.Pre-embolization Pelvic Angio CT is useful to identify anatomical variations and atherosclerotic stenosis in order to prevent technical failure.Emborrhoid technique is performed using a femoral approach. After catheterization of the inferior mesenteric artery, the SRA are then catheterized with a microcatheter.Selective angiograms are useful to recognize the target vessels feeding the corpus cavernosum recti, and the anastomosis with the middle rectal arteries.Terminal branches of the SRA are occluded by micro-coils. The embolization should be as complete and distal as possible to restrict the reloads by middle rectal arteries.Technical success of this procedure has been reported in up to 90%.
Conclusions
Hemorrhoid embolization is technically feasible and safe.Coils placement is based on a good knowledge of the vascular anatomy of rectal arteries .