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Superior Rectal Artery Embolization with Tris-Acryl Gelatin Microspheres: A Randomized Comparison of Particle Size.
- Source :
-
Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2021 Jun; Vol. 32 (6), pp. 819-825. Date of Electronic Publication: 2021 Feb 25. - Publication Year :
- 2021
-
Abstract
- Purpose: To evaluate the safety and efficacy of superior rectal artery embolization (SRAE) with different-sized tris-acryl gelatin microspheres in symptomatic hemorrhoidal disease (HD).<br />Materials and Methods: Forty-two patients (male, 30; female, 12; median age, 45 years) with symptomatic HD (2 grade I, 8 grade II, 17 grade III, and 15 grade IV) were divided into 3 experimental arms (500-700 μm, 700-900 μm, and 900-1,200 μm groups; each had 14 patients) in a prospective randomized style to perform SRAE. Follow-up was performed by rectoscopy, clinical examination, and questionnaires. The primary outcome measure was the clinical success rate at 12 months. Secondary outcome measures were technical success rate, recurrence rate, procedure-related mortality, procedure-related complications, and any outcome changes between particle sizes.<br />Results: No procedure-related deaths or major morbidities were observed. There was a 54% minor complication rate (n = 23/42) in the treated zone: 45% sustained small superficial ulcerations (n = 19/42), 7% small rectosigmoid junction ulcerations (n = 3/42), and 2% small fibrotic scar tissue (n = 1/42). The clinical success rate was 93%. Of the groups, the best French bleeding score decrease was obtained in the 900-1,200 μm group. There were improvements in the quality of life score and visual analogue scale score after the SRAE procedure, although not in the Goligher score. No recurrent disease was observed.<br />Conclusions: SRAE with tris-acryl gelatin microspheres for symptomatic HD is a safe and efficient treatment, with results favoring the use of larger microspheres.<br /> (Copyright © 2021 SIR. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Acrylic Resins adverse effects
Adolescent
Adult
Aged
Female
Gastrointestinal Hemorrhage diagnostic imaging
Gastrointestinal Hemorrhage etiology
Gelatin adverse effects
Hemorrhoids complications
Hemorrhoids diagnostic imaging
Humans
Male
Middle Aged
Particle Size
Prospective Studies
Quality of Life
Recurrence
Single-Blind Method
Time Factors
Treatment Outcome
Turkey
Young Adult
Acrylic Resins administration & dosage
Arteries
Embolization, Therapeutic adverse effects
Gastrointestinal Hemorrhage therapy
Gelatin administration & dosage
Hemorrhoids therapy
Rectum blood supply
Subjects
Details
- Language :
- English
- ISSN :
- 1535-7732
- Volume :
- 32
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of vascular and interventional radiology : JVIR
- Publication Type :
- Academic Journal
- Accession number :
- 33640516
- Full Text :
- https://doi.org/10.1016/j.jvir.2021.02.011