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Feasibility of Superior Rectal Artery Embolization for the Treatment of Hemorrhoidal Disease (EMBORRHOID)

This study is currently recruiting participants.
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Verified August 2016 by Assistance Publique Hopitaux De Marseille
Information provided by (Responsible Party):
Assistance Publique Hopitaux De Marseille Identifier:
First received: November 19, 2014
Last updated: August 1, 2016
Last verified: August 2016

With an estimated prevalence between 4 and 35%, the hemorrhoidal disease is the most frequent proctologic disease. Its symptoms are mainly rectorrhagia, externalization of the hemorrhoidal cushions (muco-hemorrhoidal prolapse), and/or pain and pruritus. Its acute complications (external and/or internal thromboses) are unpredictable.

Surgical treatment concerns approximately 10% of patients with diagnosed hemorrhoidal pathologies. The elective ligature of the arteria haemorrhoidalis under trans-anal Doppler scanning was developed in order to reduce the postoperative morbidity of hemorrhoidal surgery. This technique consists in a ligation of the superior rectal artery under Doppler control in order to decrease the blood flow within the hemorrhoids and therefore to reduce them. It is effective in the treatment of internal hemorrhoidal pathology without prolapse (grade II). The complications rate is low and estimated between 2 and 12% : rectorrhagia (4.3%), thrombosed hemorrhoids (1,8%), fissure (0,8%), acute urine retention (0,7%).

With the major advances in interventional radiology such ligation could be performed by an endovascular coil embolization. Until now no direct study exists on the subject but several case reports show the feasibility of an embolization of the superior rectal arteries for rectorrhagia of various etiologies such as the hemorrhoidal disease.

Endovascular access should increase the selectivity of the embolization compared to the Doppler scanning technique. Indeed the arteriography makes it possible to scan all branches of the superior rectal artery and therefore to occlude permanently the branches that feed the hemorrhoidal plexuses. Moreover the endovascular embolization technique should avoid the main complications of the trans-anal access technique.

The primary objective of this study is : the assessment of the efficacy of endovascular coil embolization of the superior rectal arteries in the management of the symptoms of the hemorrhoidal disease grade II and III. The secondary objective is : the assessment of postoperative complications.

Condition Intervention
Hemorrhoidal Disease Device: NESTER COILS

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Feasibility of Superior Rectal Artery Embolization for the Treatment of Hemorrhoidal Disease

Further study details as provided by Assistance Publique Hopitaux De Marseille:

Primary Outcome Measures:
  • Decrease of the felt pain [ Time Frame: 26 MONTHS ]
    It will be expected a decrease of the felt pain at least of 2 points measured by visual analog scale for patients treated by coil embolization

Secondary Outcome Measures:
  • Reaaparition or obstinacy of the hemorroidal symptoms [ Time Frame: 26 months ]
    Reaaparition or obstinacy of the symptoms will be assess by clinical exam at 1,3,6 and 12 months

Estimated Enrollment: 26
Study Start Date: November 2014
Estimated Study Completion Date: November 2017
Estimated Primary Completion Date: February 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: coils Device: NESTER COILS


Ages Eligible for Study:   18 Years to 75 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Suffering from a symptomatic hemorrhoidal disease stage II or III (history of prior medical treatment or instrumental do not prohibit the inclusion in the study)
  • Patient agreeing to participate in the study and who signed an informed consent
  • Patient willing to lend to post-operative monitoring for a year
  • Patient assured social

Exclusion Criteria:

  • Diseases and colorectal proctologic / History proctologic
  • Acute Complication hemorrhoidal disease course (thrombosis)
  • History of proctology surgery for hemorrhoidal disease
  • Anal stenosis congenital or acquired
  • Chronic anal fissure, anal suppuration associated
  • Chronic Inflammatory Bowel Disease
  • History of colorectal cancer
  • History of rectal resection and / or sigmoid
  • Rectal prolapse
  • Comorbidities
  • Portal hypertension
  • Severe atherosclerotic pathology (significant stenosis in aorto-iliac-femoral artery or branches for visceral).
  • General Affection responsible for a disorder of hemostasis objective (hemophilia, von Willebrand disease thrombocytopenia) and anticoagulants.
  • Psychiatric disorder making it impossible informed of and / or postoperative care
  • Neurological disease directly or indirectly involving the rectosphinctérienne motor (multiple sclerosis, spinal cord injury or nerve root, polyneuropathy).
  • Patients whose condition appears too insecure or taking steroids or immunosuppressive leading to an unacceptable surgical risk.
  • Background
  • Pregnancy declared (the existence of effective contraception will be checked for women of childbearing age)
  • Major Trust
  • Patients who do not speak French, refusing or unfit for monitoring proposed in the study
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT02303925


Assistance Publique Hopitaux de Marseille Recruiting
Marseille, France, 13005
Sponsors and Collaborators
Assistance Publique Hopitaux De Marseille
Study Director: Urielle DESALBRES Assistance Publique Hopitaux De Marseille
Principal Investigator: vincent vidal Assistance Publique Hopitaux De Marseille
  More Information

Responsible Party: Assistance Publique Hopitaux De Marseille Identifier: NCT02303925     History of Changes
Other Study ID Numbers: 2014-A00111-46
Study First Received: November 19, 2014
Last Updated: August 1, 2016 processed this record on September 21, 2017