56 - Outcomes from Hemorrhoidal Artery Embolization in a Multidisciplinary Outpatient Interventional Center: A Review of 211 Patients

Alex Pavidapha, MD¹, Abin Sajan, MD², Jade Lerner, MD¹, Rachel Piechowiak, DO¹, Atul Marathe, MD³, Ari Isaacson, MD¹, Sandeep Bagla, MD^1
1Hemorrhoid Centers USA, Falls Church, VA; ²Columbia University Irving Medical Center, New York, NY; ³Gastro Health, Woodbridge, VA

Introduction: To evaluate the safety and efficacy of outpatient transarterial embolization for symptomatic refractory internal hemorrhoids.

Methods: 211 patients with symptomatic bleeding internal hemorrhoids refractory to prior treatment were treated with Hemorrhoidal Artery Embolization (HAE) between August 2021 and March 2023 (113 males and 98 females). The average age was 56.2 years with an average Goligher's hemorrhoid grade (HG) of 2.8. Patients underwent superior and/or middle rectal artery embolization to the target arteries demonstrating abnormal vascular blush of the hemorrhoidal cushion with spherical particles (600 micron) and/or microcoils (2-6 mm). Patients were discharged the same day and evaluated at baseline, 1-, 3-, and 6-months for the following standardized outcomes: hemorrhoid related pain (HRP, 0-10), hemorrhoid symptoms score (HSS, 5-20), quality of life (QoL, 0-4), French bleeding score (FBS, 0-9), and HG (0-4).

Results: Technical success was achieved in 210/211 patients (99%). The average number of SRA branches embolized per patient was 2.9 +/- 1.0. Clinical success was seen in 91% (191/211) of patients at 1-month follow-up after the procedure with 20 patients requiring repeat embolization.

Significant improvements were demonstrated for all outcomes across all timepoints with the following 1-month results: HSS (10.8 to 8.0, p < 0.01), HRP (3.9 to 1.4, p < 0.01), QoL (2.1 to 0.9, p < 0.01), FBS (4.2 to 2.3, p < 0.01), and HG (2.8 to 2.3, p < 0.01). Two adverse events were reported and resolved by 30 days post-procedure.

Discussion: Hemorrhoidal artery embolization is a safe and effective outpatient treatment for refractory symptomatic internal hemorrhoids.


Disclosures:


Alex Pavidapha, MD¹, Abin Sajan, MD², Jade Lerner, MD¹, Rachel Piechowiak, DO¹, Atul Marathe, MD³, Ari Isaacson, MD¹, Sandeep Bagla, MD¹, 56, Outcomes from Hemorrhoidal Artery Embolization in a Multidisciplinary Outpatient Interventional Center: A Review of 211 Patients, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.