Mid-Term Results of Superior Rectal Artery and Coils for Hemorrhoidal Embolization with Particles Bleeding

Catheter-Directed Hemorrhoidal Dearterialization Technique for the Management of Hemorrhoids: A Meta-Analysis of the Clinical Evidence

“…The total number of patients who underwent CDHD in these studies (4,10,11,13-23) was 362 (Table 1). One study (4) was conducted before 2015 and the remaining after 2016 (10,11,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Six (10,14,18,20,22,23) and 8 studies (4,11,13,(15)(16)(17)19,21) were retrospective and prospective case series, respectively.…”

“…One study (4) was conducted before 2015 and the remaining after 2016 (10,11,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Six (10,14,18,20,22,23) and 8 studies (4,11,13,(15)(16)(17)19,21) were retrospective and prospective case series, respectively. Of them, only 1 study (13) reported the results of direct comparison with a surgical treatment, although not in a randomized fashion.…”

“…No statistically significant difference was observed when comparing technical success between the coils only and coils and particles groups. Four studies (10,11,13,15) reported bleeding scores before and after embolization (n ¼ 98) (Table 2). The mean bleeding score before embolization was 6.8 (SD, 0.90; range, 5.5-7.6), which decreased to a mean score of 3.9 (SD, 0.90; range, 2.8-5) after embolization (Fig 3); this difference was statistically significant (P ¼ .004).…”

“…The noncomparative studies (1,10,(13)(14)(15)(16)(17)(18)(19)(20)(21)23) included in this review scored between 5 and 12 of a maximum of 16. The comparative studies (11,22)…”

“…Bleeding severity is scored by considering the frequency of bleeding, triggers of bleeding, and whether the patient is suffering from anemia due to the bleeding. Moussa et al (11) further developed this bleeding score into the Paris bleeding severity score, which also takes into account the severity of discomfort experienced to calculate a score up to a maximum of 9.…”