Purpose: The purpose of this study was to prospectively evaluate the efficacy and safety of a new, bare platinum, detachable microcoil as a metallic embolization agent in the treatment of hemorrhoidal disease. Material and Methods: This prospective single-center study evaluated a new, bare platinum, electrical, detachable microcoil (Prestige plus coil (Balt Montmorency France)) for use in vascular embolization in patients with hemorrhoidal disease. Between January 2020 and January 2021, 24 embolization procedures were performed in 21 patients (12 males, 9 females; mean age 44.3 ± 7.3). The inclusion criteria were: (a) participants with grade I, II and III hemorrhoidal disease on the Goligher classification; (b) patients older than 18 years of age with a score of greater than 4 on the French bleeding score (FBS) scale; (c) patients with scores greater than 2 on the scale of discomfort proposed by Tradi and Farfallah. (d) patients who underwent treatment that included the use of the new novel coil (Prestige plus coil (Balt)) as an embolic material. The exclusion criteria were participants who failed to provide informed consent and participants diagnosed with rectal bleeding due to other causes (cancer, fissures or others). Participants with severe renal insufficiency, non-correctable coagulation abnormalities and adverse reactions to the contrast medium not correctable with medication were also excluded. The symptoms, technical aspects, the transarterial approach, clinical and technical success complications and short-term outcomes were assessed. Results: Technical success was obtained in 100% of the cases. Seventeen (80.9%) patients experienced improvements in their hemorrhoidal disease. The VAS and QL scores improved by 4 and 1.5 points (81.2% and 87.5%), respectively, after embolization (pV: 0001). Three (14.2%) patients underwent a second embolization due to rebleeding. One patient (4.7%) underwent surgery. No major complications were observed. Three patients had minor complications. The assessment of subjective post-treatment symptoms and QL surveys showed significant differences from the baseline survey. Likewise, the measurement of the degree of satisfaction using a telephone survey at 12 months revealed a high degree of patient satisfaction over 10 points (mean 8.3 ± 1.1). Conclusions: The present study demonstrates that the use of the new, platinum, detachable, electrical microcoil is safe and well-tolerated in the treatment of hemorrhoidal disease. Key points: Catheter-directed hemorrhoidal dearterialization (CDHD) is the procedure of embolization with embolic agents for the treatment of internal hemorrhoids. CDHD is a simple and safe procedure that is accepted by patients and preserves the anal sphincter; it presents few complications when metal devices or microspheres are used as embolic agents. As the recommended embolization agent in treatments, the Prestige electrical, detachable coil is a safe, easy-to-use and effective arterial embolic device.

RESUMEN La exposición laboral a la radiación ionizante no es un proceso inocuo, ya que puede producir efectos dañinos en la salud del personal ocupacionalmente expuesto. En el área de radiología e intervencionismo del Complejo Hospitalario Arnulfo Arias Madrid (C.H.M.Dr.A.M) no se cuenta con registros de los niveles de exposición del personal desde el 2012 y tampoco hay programas de capacitación para el personal que trabaja en áreas de riesgo. Objetivos: Determinar el nivel de bioseguridad en protección radiológica del personal ocupacionalmente expuesto que ejerce en el área de Radiología y He

Introducción: El Sangrado Digestivo (SD) es un evento clínico potencialmente mortal y un motivo frecuente de hospitalización a nivel mundial. La Embolización Arterial Transcatéter (EAT) como intervención mínimamente invasiva es una alternativa cuando falla el manejo primario. En Panamá, carecemos de literatura local sobre sus resultados. Objetivo: Describir la embolización arterial transcatéter como tratamiento alternativo en pacientes admitidos con sangrado digestivo en el Hospital Regional Dr. Rafael Hernández (HRRH), enero 2024 – junio 2025. Metodología: Se realizo un estudio observacional, descriptivo y retrospectivo mediante revisión de expedientes clínicos de pacientes que recibieron EAT en nuestra institución como tratamiento alternativo a SD entre enero 2024 y junio 2025. Se identificaron 17 pacientes, de los cuales 5 fueron excluidos por presentar SD secundario a hipertensión portal. Obteniéndose una muestra final de 12 pacientes. Se documentaron variables demográficas, clínicas, angiográficas, técnicas y de desenlace mediante estadística descriptiva. Resultados: Los grupos etarios predominantes correspondieron a pacientes de 60–79 años y ≥80 años, con 33,3% cada uno. Se observó una distribución equivalente entre ambos sexos (6 hombres y 6 mujeres). El SD bajo fue la presentación clínica más frecuente (66.7%), siendo la enfermedad hemorroidal la principal etiología. Las arterias hemorroidales superiores representaron el territorio embolizado con mayor frecuencia (58.3%). Los agentes líquidos y las partículas fueron los materiales más utilizados en un 33,3%. El éxito técnico fue del 100% y el éxito clínico del 83.3%. Se documentó recurrencia del sangrado en dos pacientes (16.7%), una complicación menor relacionada con el acceso vascular (8.3%) y una mortalidad intrahospitalaria del 16.7%. La mediana de estancia hospitalaria fue de 15 días (RIC: 7–24). Conclusión: La EAT obtuvo un éxito técnico del 100% y un éxito clínico del 83,3%, con una baja frecuencia de complicaciones relacionadas con el procedimiento en pacientes con SD no variceal intervenidos en el HRRH durante el periodo comprendido entre enero 2024 y junio 2025. Estos resultados apoyan el uso de la EAT como tratamiento alternativo en pacientes con SD que requieren de manejo endovascular.

The purpose of this study is to compare IVC Celect and ALN filters in regard to their efficacy, retrievability, and 1-year follow-up after retrieval. Materials and Methods: This is a prospective randomized study, conducted in three centers between April 2020 and May 2021. A total of 115 participants were randomized, of which 15 participants were excluded for various reasons. Each group of 50 participants was finally assigned a type of filter (Celect n= 50 and ALN= 50). Tilt angles at placement and retrieval together with rates of overall filter retrieval, complications, complex retrieval, and clinical follow-up at 12 months were compared. Results: One hundred participants (59 men and 41 women) were included. The mean age was 62.4±13.3 with no significant differences between both groups (p 0.503). The mean of dwelling time was 44.7±93 days. (p 0.520) Filter retrieval was successful in all participants (100%). The main complication in CT prior to removal was inclination > 15º (31%) and filter tip embedment (16%). No significant differences were observed in the type of retrieval (standard or complex) between both filters (p 0.24); however, fluoroscopy time was significantly longer in the complex removal of the Celect filter 29.1±12 min vs 17.5±10.3 (p 0.005). After one year, no recurrent pulmonary embolism was observed in both types of filters. Conclusion: The ALN filter had a significantly lower rate of tip and filter tip embedding with no differences in complexity or removal success rate. There were significant differences in the fluoroscopy time consumed for standard and complex retrievals between both filters with less time in the ALN filter

The purpose of this study is to compare IVC Celect and ALN filters in regard to their efficacy, retrievability, and one-year follow-up after retrieval. Materials and Methods: This is a prospective randomized study, conducted in three centers between April 2020 and May 2021. A total of 115 participants were randomized, of which 15 participants were excluded for various reasons. Each group of 50 participants was finally assigned a type of filter (Celect n = 50 and ALN = 50). Tilt angles at placement and retrieval, rates of overall filter retrieval, complications, complex retrieval, and clinical follow-up at 12 months were compared. Results: One hundred participants (59 men and 41 women) were included. The mean age was 62.4 ± 13.3, with no significant differences between both groups (p 0.503). The mean of dwelling time was 44.7 ± 93 days. (p 0.520) Filter retrieval was successful in all participants (100%). The main complication in CT prior to removal was tilt >15° (31%) and filter tip embedment (16%). No significant differences were observed in the type of retrieval (standard or complex) between both filters (p 0.24); however, fluoroscopy time was significantly longer in the complex removal of the Celect filter: 29.1 ± 12 min vs. 17.5 ± 10.3 (p 0.005). After one year, no recurrent pulmonary embolism was observed in both types of filters. Conclusions: The ALN filter had a significantly lower rate of tip and filter tip embedding, with no differences in complexity or removal success rate. There were significant differences in the fluoroscopy time consumed for standard and complex retrievals between both filters, with less time for the ALN filter.