Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques.
Julien Panneau, Diane Mege, Mathieu Di Bisceglie...
https://pubmed.ncbi.nlm.nih.gov/36190848/Actively Recruiting
Led by University of California, Los Angeles · Updated on 2026-02-02
22
Participants Needed
1
Research Sites
52 weeks
Total Duration
Researchers are evaluating hemorrhoidal artery embolization HAE, a new procedure for treating symptomatic internal hemorrhoids. HAE works by blocking enlarged arteries in the rectal or hemorrhoidal area to reduce abnormal blood flow, aiming to improve symptoms such as bleeding. Earlier reports suggest HAE may be safe and effective, but more research is needed to understand its long-term effects using different embolization materials in a broader patient population with hemorrhoidal disease. This trial involves 22 patients with grades I to III internal hemorrhoids who have symptoms including a French Bleeding Score of at least four and who have refused or cannot have surgery or other minimally invasive treatments. After an initial clinic visit to confirm eligibility, participants will receive the HAE procedure. The study includes follow-up visits in the clinic at 1, 3, 6, and 12 months after treatment to monitor progress and outcomes. Participants will be assessed for improvements in bleeding symptoms using the French Bleeding Score, as well as changes in other hemorrhoid-related symptoms, pain, and patient satisfaction. Researchers will also track the need for further medical or surgical treatments. Safety and technical success of the HAE procedure will be monitored throughout the year-long study, with all follow-up visits designed to evaluate symptom changes and overall treatment impact.
CONDITIONS
Hemorrhoidal Artery Embolization: Longitudinal Impact On Symptoms (HELIOS)
R
Renato Escobar
L
Lucas Cusumano, MD
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University of California, Los Angeles
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | HAE Procedure (Trial Arm) | Rubber Band Ligation, Infrared Coagulation, Sclerotherapy (Guideline Context) |
|---|---|---|
| What it is | An image-guided procedure in which the arteries supplying blood to the hemorrhoidal tissue are selectively blocked to reduce symptoms caused by internal hemorrhoids. | Non-surgical, minimally invasive office-based treatments for internal hemorrhoids, including rubber band ligation, infrared coagulation, and sclerotherapy, which aim to shrink or scar hemorrhoidal tissue to relieve symptoms. |
| Primary use | To improve symptoms, particularly rectal bleeding, in patients with symptomatic internal hemorrhoids who are not suitable for or decline surgery and other minimally invasive therapies. | To treat rectal bleeding and other symptoms associated with Grade I to III internal hemorrhoids, typically in patients who have not responded to conservative medical management. |
| How it is given/performed | Performed by interventional radiologists in a vascular suite using angiography to identify and block the rectal arteries with embolic material. Typically involves local anesthesia and a catheter inserted via the femoral or radial artery. | Usually performed in the office or outpatient setting without anesthesia. Rubber band ligation applies a small band to the hemorrhoid, infrared coagulation delivers heat to shrink tissue, and sclerotherapy injects a solution causing fibrosis and scarring. |
| Evidence status | Supported by multiple prospective studies and meta-analyses indicating that HAE can reduce bleeding and improve symptoms in patients with internal hemorrhoids, but long-term comparative effectiveness versus standard therapies is still under investigation. | Extensive evidence supports the efficacy of minimally invasive treatments for most patients with Grade I to III internal hemorrhoids, including bleeding reduction and symptom improvement. |
| Important limitations | Long-term safety and effectiveness remain less established compared to traditional therapies. HAE is technically complex, requires specialized equipment, and is not universally available. May not be appropriate for all hemorrhoid grades or coexisting conditions. | Risks include recurrence, discomfort, and occasional need for repeat procedures. These treatments may be insufficient for larger, higher-grade, or refractory hemorrhoids. Rare complications include pain, infection, or bleeding. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
You will not qualify if you...
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Day of procedure
Participants undergo hemorrhoidal artery embolization (HAE), a procedure that blocks enlarged arteries to reduce symptoms of internal hemorrhoids.
1 treatment visit (in-person)
Duration - 12 months
Participants are monitored for safety and symptom improvement with clinic visits following the treatment.
Follow-up visits at 1, 3, 6, and 12 months post-procedure (4 visits, in-person)
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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Lead Sponsor