Embolization of superior rectal arteries for transfusion dependent haemorrhoidal bleeding in severely cardiopathic patients: a new field of application of the “emborrhoid” technique

Excerpt

Hemorrhoids are one of the most common anorectal diseases, with a prevalence of 4–86% [1]. One of the main symptoms is recurrent painless anorectal bleeding during defecation, which, if overlooked, can cause anemia. Embolization of the superior rectal arteries (“emborrhoid technique”) with coils was recently proposed by Vidal et al. [2] as a less invasive alternative to well-known conventional surgical treatments for hemorrhoids causing significant complication. This technique has been shown to be effective, safe, and well tolerated in patients with hemorrhoidal bleeding unsuitable or unwilling to undergo surgical treatment [3]. Anticoagulant and antiplatelet therapy is crucial in many patients with chronic heart disease to avoid life-threatening thrombotic complications after cardiac surgery, coronary artery stenting, or left ventricular assist devices (LVAD) implantation, in patients experiencing heart failure. Treatment of severe hemorrhoidal bleeding in this group of “high-risk” surgical patients may be challenging, and they may benefit from non-surgical dearterialization. …