Emborrhoïd : traitement des hémorroïdes par embolisation des artères rectales

Farouk Tradi (1) , Diane Mege (2, 3) , Guillaume Louis (4) , Jean Michel Bartoli (5) , Igor Sielezneff (2, 3) , Vincent Vidal

1 Service de neuroradiologie diagnostique et interventionnelle
2 VRCM - Vascular research center of Marseille
3 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
4 CHR Metz-Thionville - Centre hospitalier régional Metz-Thionville
5 TIMONE - Hôpital de la Timone [CHU - APHM]

Although hemorrhoids are recognized as a very common cause of rectal bleeding and known for a long time, its treatment has evolved dramatically over the last twenty years.Among the new minimally invasive methods, the "Emborrhoid'' technique consists into selective embolization of hemorrhoidal arteries, branches arising from the superior rectal arteries using microcoils.This technique is based on a demonstrated pathophysiological concept of arterial network hypertrophy in hemorrhoid disease.This technique was evaluated in an animal model and then in clinical research on more than 100 patients. No ischemic complications were identified.Studies describe an improvement of 60 to 80% of the symptoms, with on average 30% recurrences at two years.The recurrence rae is likely related to a technically incomplete embolization.Future prospects are focused on more selective embolization with Particulate embolic agents.

Mots clés: Ligation

Domaines: Sciences du Vivant [q-bio]

Farouk Tradi, Diane Mege, Guillaume Louis, Jean Michel Bartoli, Igor Sielezneff, et al.. Emborrhoïd : traitement des hémorroïdes par embolisation des artères rectales. La Presse Médicale, 2019, 48 (4), pp.454-459. ⟨10.1016/j.lpm.2019.04.011⟩. ⟨hal-02570768⟩