Rectal artery embolization, or emborrhoid, is a safe, efficient, and minimally invasive intra-arterial intervention that enables selective embolization of the rectal arteries for treatment of chron... Chronic hemorrhoidal disease is a common anorectal condition that leads to hemorrhoidal hyperplasia, which affects millions of people worldwide and is a significant medical and socioeconomic issue....

Introduction: Hemorrhoidal artery embolization, also known as Emborrhoid, has emerged in recent years as a minimally invasive treatment option for patients with recurrent and unresponsive to medical therapies hemorrhoidal bleeding symptoms. We present here an overview of the profile of rectal artery embolization based on the most relevant and recent literature.Methods: A comprehensive review of literature on Hemorrhoidal artery embolization, was conducted on PubMed–Medline. The most relevant literature was summarized narratively.Results: Current literature confirms the feasibility, efficacy and safety of rectal artery embolization for bleeding hemorrhoids. To date, the results of nearly 250 patients who have undergone hemorrhoid embolization have been published in several studies. All these authors have reported high immediate technical success, with also high clinical success, ranging from 63% to 94%, without major complications. Because of its beneficial safety profile, rectal artery embolization represents an attractive option for selected patients. In case of recurrence of bleeding it is possible to consider repeating the embolization procedure. Treatment failure may be due to the presence of anatomical variants such as dominant middle rectal arteries, which can be investigated and treated in the second session if necessary.Conclusion: Rectal artery embolization represents a valuable addition to the therapeutic armamentarium of bleeding hemorrhoidal disease, if patients are selected appropriately.

Hemorrhoids are a common anorectal disease, defined as the enlargement and symptomatic prolapse of the hemorrhoidal cushions. It affects millions of people around the world and is a major medical and socioeconomic problem. In recent years, an improved anatomical understanding and the need to develop minimally invasive approaches have led to the development of the Doppler-guided hemorrhoidal artery ligation (DG-HAL) procedure as an effective treatment for hemorrhoids.[1] The DG-HAL procedure uses dedicated equipment and involves the identification of hemorrhoidal arteries using Doppler ultrasound, and their ligation to decrease the flow of arterial blood to the hemorrhoidal cushions. This procedure is performed via the transanal route under local anesthesia. This technique has several advantages: it leaves the hemorrhoidal tissue in place, preserves anal continence, and is significantly less painful and less prone to complications than open surgery, allowing patients to return to work sooner.[2] Based on the underlying principles of this technique, we have developed the “emborrhoid” embolization technique, in which endovascular occlusion of the arteries from the distal branches of the inferior mesenteric artery (IMA) is performed. Our preliminary results for this technique have been reported in other publications.[3] [4] [5] [6] [7] [8] [9] [10] Compared with DG-HAL, the endovascular approach offers the advantage of identifying all the hemorrhoidal arterial branches, recognizing anatomical variations, and ensuring effective occlusion of the target branches, which could improve therapeutic results. No comparative study between the two techniques has yet been performed. The aim of this article is to describe our team's current methods and results for the emborrhoid technique as the main alternative treatment for patients with hemorrhoids. Article published online: 30 June 2022 © 2022. Thieme. All rights reserved. Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

Background: Postpartum hemorrhage is the leading cause of maternal mortality in emerging countries. This study aims to evaluate the effectiveness and safety of uterine artery embolization (UAE) using suture fragment (FairEmbo concept) in a swine model. Methods: Seven female swine uteri were embolized. The left uterine artery was embolized with 1 cm fragments of absorbable suture (Optime^® 0), and with gelatin sponge torpedoes for the contralateral side for comparison. The embolization effectiveness and the time for arterial recanalization with digital subtraction angiography (DSA) controls at D0, D7, and M1, were evaluated. Follow-up protocol also included clinical monitoring and macroscopical analyses at M1. A Mann–Whitney test (significance at P 0.05) was used for statistics. Results: A technical success was obtained for the seven arteries on each side, with no off-target embolization. The procedure time (10 min versus 3.7 min) and number of fragments (13.8 versus 5.7) required for complete occlusion were significantly greater in the FairEmbo group. All arteries were repermeabilized at M1. No necrosis was macroscopically visible at harvest at M1. Conclusion: This experimental study suggests that UAE with SBM FairEmbo method is feasible, safe, and effective in comparison with gelatin sponge procedure.

Background: Embolization is a key therapeutic option in interventional radiology for the management of acute arterial bleeding and solid organ injuries. While various embolic agents exist, there is a persistent clinical need for materials that are not only highly effective but also biocompatible, easy to deliver, and cost-effective. We aim to evaluate a new eco-friendly dry foam agar-based embolization agent (ABEA) in an uncontrolled solid organ hemorrhage model. Material and Methods: Ten pigs underwent a controlled splenic injury. After a 5 min free-bleeding period, five pigs were treated with splenic artery ABEA embolization, while the remaining five received no treatment and served as the control group. Follow-up angiography was performed immediately after embolization and at 5 and 15 min in the treated pigs. Mean arterial pressures and average blood loss volumes were evaluated for 120 min. Results: The control group showed continuous blood loss, leading to a significantly higher total blood loss than the ABEA-treated group (1451 mL vs. 611 mL at 120 min, p < 0.05). Mean arterial pressure (MAP) remained below the hemorrhagic shock threshold throughout the procedure in the control group, validating the model of uncontrolled hemorrhage. In addition, a significant stabilization of MAP was observed in treated pigs, remaining above the critical level of hemorrhagic shock and differed significantly from control group values. Conclusions: Embolization with ABEA maintained MAP above critical levels and significantly reduced blood loss volume in a hemorrhagic model. These results support the technical feasibility and short-term hemostatic performance of ABEA in an acute setting. While preliminary, this proof-of-concept has provided the basis for a validated clinical study currently underway to evaluate its effectiveness and safety in human patients.