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Vincent Vidal - One of the best experts on this subject based on the ideXlab platform.
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Embolization of the Superior Rectal Arteries for Hemorrhoidal Disease: Prospective Results in 25 Patients.
Journal of vascular and interventional radiology : JVIR, 2018Co-Authors: F. Tradi, Igor Sielezneff, G. Louis, Roch Giorgi, Diane Mege, Jean-michel Bartoli, Vincent VidalAbstract:PURPOSE To evaluate efficacy and safety of superior Rectal Artery embolization of hemorrhoidal disease as a first-line invasive treatment. MATERIALS AND METHODS This prospective study was conducted between 2014 and 2015 on 25 consecutive patients (16 men and 9 women with a mean age of 53 y [range, 30-76 y]) with grade II-III hemorrhoids refractory to medical treatment. A transfemoral superselective superior Rectal Artery branch embolization was performed using 2- and 3-mm diameter microcoils. Over the following 12 months, clinical outcomes were evaluated using the French bleeding score, Goligher prolapse score, visual analog scale (VAS) score for pain, quality-of-life score. The primary endpoint was relief of symptoms by 12 months based on a 2-point minimum improvement on VAS score and bleeding score. RESULTS At 12 months after embolization, clinical success was obtained in 18 patients (72%), 8 of whom had 2 embolizations. VAS score decreased from 4.6 to 2.3 (P < .01), and bleeding score decreased from 5.5 to 2.3 (P < .01). Quality-of-life and prolapse scores also showed improvement (P < .05), and no patients experienced any early or late complications. Complete clinical failure was observed in 7 patients. After coil embolization, the collateral supply to the hemorrhoidal cushions was significantly related to any recurrence (P = .001). CONCLUSIONS Hemorrhoidal Artery coil embolization was found to be a safe and effective treatment for grade II-III hemorrhoids.
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Safety and efficacy of superior Rectal Artery embolization with particles and metallic coils for the treatment of hemorrhoids (Emborrhoid technique).
Diagnostic and interventional imaging, 2016Co-Authors: A. A. Zakharchenko, Y. Kaitoukov, Y. Vinnik, F. Tradi, Marc Sapoval, Igor Sielezneff, E. Galkin, Vincent VidalAbstract:Abstract Purpose The purpose of this study was to comprehensively evaluate the short-term outcomes after percutaneous embolization of the superior Rectal Artery (SRA) with metallic coils and particles for the management of hemorrhoids. Materials and methods Forty patients (15 men, 25 women) with a mean age of 35 ± 5 years (SD) (range: 25–65 years) were prospectively enrolled. All patients had symptomatic hemorrhoids. The distribution of internal hemorrhoids was as follows: grade I ( n = 6, 16%); grade II ( n = 28, 69%) and grade III ( n = 6; 15%). All patients had percutaneous embolization of the SRA with metallic coils and synthetic polyvinyl alcohol particles. Follow-up evaluation included clinical examination, rectoscopy, histopathological analysis of Rectal mucosa, duplex Doppler blood flow quantification, electromyography, sphincterometry of the anal sphincter and analysis of patient satisfaction. Results No immediate complications were observed and no patients had anal pain syndrome after embolization. Hemorrhoids showed a 43% size reduction after embolization ( P P Conclusion Our study demonstrates that embolization of SRA with particle and coils does not lead to ischemia in patients with symptomatic hemorrhoids. Short-term results with regard to symptom management for hemorrhoidal disease are very encouraging and should stimulate further prospective and multicenter studies.
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Embolization of the hemorrhoidal arteries (the emborrhoid technique): a new concept and challenge for interventional radiology.
Diagnostic and interventional imaging, 2014Co-Authors: Vincent Vidal, G. Louis, Jean-michel Bartoli, Igor SielezneffAbstract:Abstract Elective transanal Doppler-guided hemorrhoidal Artery ligation (DG-HAL) has recently been shown to be effective in hemorrhoidal disease. It consists of ligating the terminal branches of the superior Rectal Artery under Doppler guidance, in order to reduce the hemorrhoidal arterial blood flow and improve the symptoms. By analogy, we propose performing this arterial occlusion using the “emborrhoid” technique (embolization of the hemorrhoidal arteries), in which arterial occlusion is achieved via the endovascular route using coils placed in the terminal branches of the superior Rectal arteries. Three patients have been treated by this new technique, and the observations show that it is feasible and reproducible, with no ischemic complications or pain. Additional studies are needed to evaluate the efficacy of this technique for the treatment of hemorrhoidal disease.
Xuemin Wang - One of the best experts on this subject based on the ideXlab platform.
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superior Rectal Artery embolization for bleeding internal hemorrhoids
Techniques in Coloproctology, 2021Co-Authors: Xinqiang Han, F. Xia, Gang Chen, Yuguo Sheng, Wenming Wang, Z. Wang, Mengpeng Zhao, Xuemin WangAbstract:The aim of the present study was to evaluate clinical efficacy and safety of superselective embolization of the superior Rectal Artery (SRA) for the treatment of internal hemorrhoidal bleeding. Patients with stage II and stage III internal hemorrhoids, treated by interventional embolization of the SRA in our department between January 2017 and June 2019 were retrospectively evaluated. All patients suffering from disabling chronic hematochezia and some with relative contraindications for operation (n = 17) or rejection of conventional hemorrhoidectomy (n = 15). Superselective SRA branch embolization was performed using gelatin sponge particles (350–560 μm) and metallic coils (2–3 mm). This treatment process was planned by a multidisciplinary team consisting of proctologist, gastroenterologist and radiologist. The surgical efficacy, postoperative complications and follow-up outcomes were observed. There were 32 patients (18 males, mean age 52 ± 12 years, range: 22–78 years), 12 (37%) with stage II hemorrhoids and 20 (63%) with stage III hemorrhoids. Embolization was successful in all patients, and bleeding symptoms resolved in 27 (84.4%) patients. The remaining 5 (15.6%) patients underwent either stapled hemorrhoidopexy (n = 4) or sclerotherapy (n = 1). Some patients experienced different degrees of pain (n = 4;12.5%), low fever (n = 11;34.4%), and tenesmus (n = 17;53.1%), which all spontaneously regressed without further treatment. All patients were followed up for at least 1 year. There were no serious complications, such as infection, intestinal ischemia or massive hemorrhage. Four patients (14.8%) had rebleeding during the first months of follow-up. All patients with re-bleeding were successfully treated with internal iliac arteriography and branch embolization and did not experience further bleeds after a minimum follow up 3 months follow-up. The short-term efficacy of superselective SRA embolization for grade II–III internal hemorrhoids is good, and this method is safe and feasible.
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Superior Rectal Artery embolization for bleeding internal hemorrhoids.
Techniques in coloproctology, 2020Co-Authors: Xinqiang Han, F. Xia, Gang Chen, Yuguo Sheng, Wenming Wang, Z. Wang, Mengpeng Zhao, Xuemin WangAbstract:BACKGROUND The aim of the present study was to evaluate clinical efficacy and safety of superselective embolization of the superior Rectal Artery (SRA) for the treatment of internal hemorrhoidal bleeding. METHODS Patients with stage II and stage III internal hemorrhoids, treated by interventional embolization of the SRA in our department between January 2017 and June 2019 were retrospectively evaluated. All patients suffering from disabling chronic hematochezia and some with relative contraindications for operation (n = 17) or rejection of conventional hemorrhoidectomy (n = 15). Superselective SRA branch embolization was performed using gelatin sponge particles (350-560 μm) and metallic coils (2-3 mm). This treatment process was planned by a multidisciplinary team consisting of proctologist, gastroenterologist and radiologist. The surgical efficacy, postoperative complications and follow-up outcomes were observed. RESULTS There were 32 patients (18 males, mean age 52 ± 12 years, range: 22-78 years), 12 (37%) with stage II hemorrhoids and 20 (63%) with stage III hemorrhoids. Embolization was successful in all patients, and bleeding symptoms resolved in 27 (84.4%) patients. The remaining 5 (15.6%) patients underwent either stapled hemorrhoidopexy (n = 4) or sclerotherapy (n = 1). Some patients experienced different degrees of pain (n = 4;12.5%), low fever (n = 11;34.4%), and tenesmus (n = 17;53.1%), which all spontaneously regressed without further treatment. All patients were followed up for at least 1 year. There were no serious complications, such as infection, intestinal ischemia or massive hemorrhage. Four patients (14.8%) had rebleeding during the first months of follow-up. All patients with re-bleeding were successfully treated with internal iliac arteriography and branch embolization and did not experience further bleeds after a minimum follow up 3 months follow-up. CONCLUSIONS The short-term efficacy of superselective SRA embolization for grade II-III internal hemorrhoids is good, and this method is safe and feasible.
Igor Sielezneff - One of the best experts on this subject based on the ideXlab platform.
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Embolization of the Superior Rectal Arteries for Hemorrhoidal Disease: Prospective Results in 25 Patients.
Journal of vascular and interventional radiology : JVIR, 2018Co-Authors: F. Tradi, Igor Sielezneff, G. Louis, Roch Giorgi, Diane Mege, Jean-michel Bartoli, Vincent VidalAbstract:PURPOSE To evaluate efficacy and safety of superior Rectal Artery embolization of hemorrhoidal disease as a first-line invasive treatment. MATERIALS AND METHODS This prospective study was conducted between 2014 and 2015 on 25 consecutive patients (16 men and 9 women with a mean age of 53 y [range, 30-76 y]) with grade II-III hemorrhoids refractory to medical treatment. A transfemoral superselective superior Rectal Artery branch embolization was performed using 2- and 3-mm diameter microcoils. Over the following 12 months, clinical outcomes were evaluated using the French bleeding score, Goligher prolapse score, visual analog scale (VAS) score for pain, quality-of-life score. The primary endpoint was relief of symptoms by 12 months based on a 2-point minimum improvement on VAS score and bleeding score. RESULTS At 12 months after embolization, clinical success was obtained in 18 patients (72%), 8 of whom had 2 embolizations. VAS score decreased from 4.6 to 2.3 (P < .01), and bleeding score decreased from 5.5 to 2.3 (P < .01). Quality-of-life and prolapse scores also showed improvement (P < .05), and no patients experienced any early or late complications. Complete clinical failure was observed in 7 patients. After coil embolization, the collateral supply to the hemorrhoidal cushions was significantly related to any recurrence (P = .001). CONCLUSIONS Hemorrhoidal Artery coil embolization was found to be a safe and effective treatment for grade II-III hemorrhoids.
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Safety and efficacy of superior Rectal Artery embolization with particles and metallic coils for the treatment of hemorrhoids (Emborrhoid technique).
Diagnostic and interventional imaging, 2016Co-Authors: A. A. Zakharchenko, Y. Kaitoukov, Y. Vinnik, F. Tradi, Marc Sapoval, Igor Sielezneff, E. Galkin, Vincent VidalAbstract:Abstract Purpose The purpose of this study was to comprehensively evaluate the short-term outcomes after percutaneous embolization of the superior Rectal Artery (SRA) with metallic coils and particles for the management of hemorrhoids. Materials and methods Forty patients (15 men, 25 women) with a mean age of 35 ± 5 years (SD) (range: 25–65 years) were prospectively enrolled. All patients had symptomatic hemorrhoids. The distribution of internal hemorrhoids was as follows: grade I ( n = 6, 16%); grade II ( n = 28, 69%) and grade III ( n = 6; 15%). All patients had percutaneous embolization of the SRA with metallic coils and synthetic polyvinyl alcohol particles. Follow-up evaluation included clinical examination, rectoscopy, histopathological analysis of Rectal mucosa, duplex Doppler blood flow quantification, electromyography, sphincterometry of the anal sphincter and analysis of patient satisfaction. Results No immediate complications were observed and no patients had anal pain syndrome after embolization. Hemorrhoids showed a 43% size reduction after embolization ( P P Conclusion Our study demonstrates that embolization of SRA with particle and coils does not lead to ischemia in patients with symptomatic hemorrhoids. Short-term results with regard to symptom management for hemorrhoidal disease are very encouraging and should stimulate further prospective and multicenter studies.
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Embolization of the hemorrhoidal arteries (the emborrhoid technique): a new concept and challenge for interventional radiology.
Diagnostic and interventional imaging, 2014Co-Authors: Vincent Vidal, G. Louis, Jean-michel Bartoli, Igor SielezneffAbstract:Abstract Elective transanal Doppler-guided hemorrhoidal Artery ligation (DG-HAL) has recently been shown to be effective in hemorrhoidal disease. It consists of ligating the terminal branches of the superior Rectal Artery under Doppler guidance, in order to reduce the hemorrhoidal arterial blood flow and improve the symptoms. By analogy, we propose performing this arterial occlusion using the “emborrhoid” technique (embolization of the hemorrhoidal arteries), in which arterial occlusion is achieved via the endovascular route using coils placed in the terminal branches of the superior Rectal arteries. Three patients have been treated by this new technique, and the observations show that it is feasible and reproducible, with no ischemic complications or pain. Additional studies are needed to evaluate the efficacy of this technique for the treatment of hemorrhoidal disease.
Lei Liang - One of the best experts on this subject based on the ideXlab platform.
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Laparoscopic radical treatment with preservation of left colon Artery and superior Rectal Artery for sigmoid colon cancer
Translational cancer research, 2018Co-Authors: Debing Shi, Lei LiangAbstract:During the classical radical treatment for sigmoid colon cancer, ligation of the inferior mesenteric Artery (IMA) at its root is typically performed to achieve better dissection of central and intermediate lymph node groups and improve the surgical outcomes. However, the blood supply to the left colon Artery (LCA), sigmoid Artery, and superior Rectal Artery (SRA) is blocked after the ligation at the root of the IMA. Here, we report laparoscopic radical treatment with preservation of the LCA and SRA for sigmoid colon cancer to preservation of blood supply to the anastomosis. The method was indicated to treat cancer at the middle portion of sigmoid colon. In the operation, we careful dissection of IMA exposes the trunk of IMA. The surrounding lymphatic tissue is dissected from the IMA root to its distal end. The LCA is preserved. After IMA divides LCA, 2–5 sigmoid colon arteries are transected one after another at the distal end of the LCA until it further divides into left and right Rectal arteries before entering the lateral wall of rectum. The inferior mesenteric vein (IMV) is transected at the lower edge of the pancreas, and the mesorectum is cut open towards the spleen curvature at the lower edge of the pancreas. Other procedures are similar with IMA high ligation surgery. Generally, LCA and SRA can be successfully preserved, and if necessary, the colonic splenic flexure should be mobilized to ensure that there is no tension at the anastomosis. The operation doesn’t significantly prolonged operation, but retrieved comparable lymph node counts with IMA high ligation surgery. Dissection of the lymphoadipose tissues at the root of IMA with the preservation of LCA and SRA is an easily performed surgery. It guarantees further prospective clinical research to compare the anastomosis leakage and oncological outcome with IMA high ligation surgery.
Yan Feng - One of the best experts on this subject based on the ideXlab platform.
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Neoadjuvant concurrent chemoradiotherapy plus superior Rectal arterial infusion chemotherapy in locally advanced Rectal cancer (LARC): A pilot study from a single institute.
Journal of Clinical Oncology, 2015Co-Authors: Dong Wang, Jinlu Shan, Yi Qing, Hualiang Xiao, Yan FengAbstract:e14608 Background: Rectal cancer represents 30% of all coloRectal cancers, with about 40,000 new cases per year. In the past two decades the management of Rectal cancer has made important progress highlighting the important role of a multimodal strategic approach that combines surgery, radiation therapy and chemotherapy. Nowadays, surgery remains the primary treatment and neo-adjuvant chemoradiotherapy, based on fluoropyrimidine continuous infusion, is considered the standard in locally advanced Rectal cancer (LARC). Arterial infusion through the superior Rectal Artery is conventionally used in palliative care of inoperable LARC, while its application in neoadjuvant therapy of LARC remains unreported. Methods: Twenty-four patients with LARC (clinically T3-4, any N) were randomized in two arms: those treated with neoadjuvant concurrent systematic chemoradiotherapy consisting of 46Gy/23/ff concurrent with S1 (40-60 mg bid) and on days 1-28 (NACT-RT) or concurrent superior Rectal Artery chemotherapy infusion...