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Background <p>Superior rectal artery embolization (“Emborrhoid”) offers a catheter-based alternative for grade I–III internal hemorrhoids when office therapies fail or surgery is undesirable.</p> Methods <p>Following PRISMA 2020, PubMed and Embase were searched (Jan 2014–Jan 2024). Two reviewers independently screened records, extracted data, and applied RoB 2, ROBINS-I, or an adapted Newcastle–Ottawa Scale. Prespecified outcomes were technical success, clinical success (≥ 2-point fall in bleeding score or equivalent), adverse events, and recurrence. Substantial heterogeneity blocked meta-analysis; results were narratively synthesized.</p> Results <p>Twenty-two studies encompassing 810 procedures qualified. Technical success reached 93–100%. Clinical success ranged from 63 to 94%, yielding marked bleeding control and symptom relief. Reported complications were mild and self-limited (pelvic discomfort, nausea, and low-grade fever); no ischemic injury, continence disturbance, or mortality occurred. Recurrence necessitating repeat treatment affected 8–20% of patients, usually when collateral arterial supply persisted. Patient-reported satisfaction exceeded 80% in every series. Only two small, heterogeneous comparative studies versus rubber-band ligation or sclerotherapy were available, precluding a pooled analysis.</p> Conclusions <p>Current evidence suggests Emborrhoid is a safe, effective bridge between office procedures and surgery—particularly valuable for frail or anticoagulated patients. Yet small single-center cohorts, disparate techniques, and scarce head-to-head trials limit external validity. Multicenter randomized studies with harmonized outcomes and ≥ 24-month follow-up are required to confirm long-term efficacy, cost-effectiveness, and optimal patient selection.</p>

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Outcomes of embolization therapy of superior rectal arteries for the management of grade 1 to 3 internal hemorrhoids: a systematic Review of clinical studies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月29日

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  • Mustafa Al Jnainati,
  • Niharika Ikkurthy,
  • Mohammad Ayoub,
  • Areeba Shahid,
  • Mirza Taha Baig,
  • Muhammad Iltaf,
  • Jana Al Jnainati

摘要

Background

Superior rectal artery embolization (“Emborrhoid”) offers a catheter-based alternative for grade I–III internal hemorrhoids when office therapies fail or surgery is undesirable.

Methods

Following PRISMA 2020, PubMed and Embase were searched (Jan 2014–Jan 2024). Two reviewers independently screened records, extracted data, and applied RoB 2, ROBINS-I, or an adapted Newcastle–Ottawa Scale. Prespecified outcomes were technical success, clinical success (≥ 2-point fall in bleeding score or equivalent), adverse events, and recurrence. Substantial heterogeneity blocked meta-analysis; results were narratively synthesized.

Results

Twenty-two studies encompassing 810 procedures qualified. Technical success reached 93–100%. Clinical success ranged from 63 to 94%, yielding marked bleeding control and symptom relief. Reported complications were mild and self-limited (pelvic discomfort, nausea, and low-grade fever); no ischemic injury, continence disturbance, or mortality occurred. Recurrence necessitating repeat treatment affected 8–20% of patients, usually when collateral arterial supply persisted. Patient-reported satisfaction exceeded 80% in every series. Only two small, heterogeneous comparative studies versus rubber-band ligation or sclerotherapy were available, precluding a pooled analysis.

Conclusions

Current evidence suggests Emborrhoid is a safe, effective bridge between office procedures and surgery—particularly valuable for frail or anticoagulated patients. Yet small single-center cohorts, disparate techniques, and scarce head-to-head trials limit external validity. Multicenter randomized studies with harmonized outcomes and ≥ 24-month follow-up are required to confirm long-term efficacy, cost-effectiveness, and optimal patient selection.