N Moussa1,2, B Bonnet3,4, H Pereira5,6, L Pechmajou3,4, O Pellerin3,4,7, A Abed3,4, C Del Giudice3,4, C Dean3,4, D Bouda8, V de Parades9, N Fathallah9, M Sapoval3,4,7. 1. Sorbonne Paris Cité, Medicine Faculty, Paris Descartes University, Paris, France. nadia.moussa@aphp.fr. 2. Assistance Publique Hôpitaux de Paris, Interventional Radiology Department, Georges Pompidou European Hospital, 20 Rue Leblanc, 75015, Paris, France. nadia.moussa@aphp.fr. 3. Sorbonne Paris Cité, Medicine Faculty, Paris Descartes University, Paris, France. 4. Assistance Publique Hôpitaux de Paris, Interventional Radiology Department, Georges Pompidou European Hospital, 20 Rue Leblanc, 75015, Paris, France. 5. Unité d'épidémiologie et de Recherche Clinique, Assistance Publique Hôpitaux de Paris, Georges Pompidou European Hospital, Paris, France. 6. Centre d'Investigation Clinique 1418, Module d'épidémiologie Clinique, INSERM, Paris, France. 7. INSERM U970, Paris, France. 8. Radiology Department, Assistance Publique Hôpitaux de Paris, Saint Louis Hospital, Paris, France. 9. Department of Proctology, Saint Joseph Hospital, Paris, France.
Abstract
OBJECTIVES: To compare safety and clinical outcomes of embolization of the superior rectal arteries in patients with hemorrhoidal bleeding using particles and coils versus coils only. METHODS: We retrospectively reviewed data for patients undergoing embolization for chronic hemorrhoidal bleeding from January 2014 to April 2017. Embolization was performed with coils alone or with particles and coils. Clinical scores (Paris bleeding severity score, Goligher classification and quality of life score) were obtained, and embolization was performed with microparticles (300-500 μm) followed by fibered pushable coils. Clinical success was defined as an improvement of > 2 points in the Paris bleeding severity score, without complications. Outcomes were compared between the two groups in a matched-pairs analysis (1:1 scenario), with patients embolized with particles and coils as the study group and patients embolized with coils alone as the control. RESULTS: We treated 45 consecutive patients. After matched-pairs analysis, the final study population was 38 patients (19 study group and 19 controls). Clinical success did not differ significantly between the two populations: 63% for control group and 68% for the study group (p = 0.790). The median change in clinical score was - 3 [- 6; - 1] for the control group and - 3 [- 4; - 1] for the study group (p = 0.187). Grade 1 complications were reported in 15% of patients, with no major complications. CONCLUSIONS: Embolization was feasible, with a technical success of 100% and no major complications. Clinical success was obtained in 66% in patients with no difference when using combined embolization with particles and coils versus coils only.
OBJECTIVES: To compare safety and clinical outcomes of embolization of the superior rectal arteries in patients with hemorrhoidal bleeding using particles and coils versus coils only. METHODS: We retrospectively reviewed data for patients undergoing embolization for chronic hemorrhoidal bleeding from January 2014 to April 2017. Embolization was performed with coils alone or with particles and coils. Clinical scores (Paris bleeding severity score, Goligher classification and quality of life score) were obtained, and embolization was performed with microparticles (300-500 μm) followed by fibered pushable coils. Clinical success was defined as an improvement of > 2 points in the Paris bleeding severity score, without complications. Outcomes were compared between the two groups in a matched-pairs analysis (1:1 scenario), with patients embolized with particles and coils as the study group and patients embolized with coils alone as the control. RESULTS: We treated 45 consecutive patients. After matched-pairs analysis, the final study population was 38 patients (19 study group and 19 controls). Clinical success did not differ significantly between the two populations: 63% for control group and 68% for the study group (p = 0.790). The median change in clinical score was - 3 [- 6; - 1] for the control group and - 3 [- 4; - 1] for the study group (p = 0.187). Grade 1 complications were reported in 15% of patients, with no major complications. CONCLUSIONS: Embolization was feasible, with a technical success of 100% and no major complications. Clinical success was obtained in 66% in patients with no difference when using combined embolization with particles and coils versus coils only.
Authors: Miguel Angel De Gregorio; Román Bernal; Juan Jose Ciampi-Dopazo; José Urbano; Alfonso Millera; José Andres Guirola Journal: J Clin Med Date: 2022-05-28 Impact factor: 4.964