Short- and Medium-Term Efficacy of Super-Selective Haemorrhoidal Artery Embolisation for Internal Haemorrhoids and Its Relationship With Severity Grading: A Single-Centre Retrospective Study.

Abstract

Objective: To evaluate the 12-month symptom relief rate of super-selective haemorrhoidal artery embolisation (HAE) for Grade I-IV internal haemorrhoids and analyse the impact of haemorrhoid grading and embolisation site on treatment efficacy.

Methods: A retrospective analysis was conducted on 32 patients with internal haemorrhoids who underwent HAE at the Interventional Radiology Department of The Second Affiliated Hospital of Soochow University between April 2020 and January 2025. Efficacy was assessed using Visual Analogue Scale (VAS) and French Bleeding Scale (FBS) scores at 1, 3, 6, and 12 months postoperatively.

Results: The clinical success rate at 1 month post-procedure (defined as clinical success: ≥ 50% reduction in VAS or FBS from baseline without requiring any reintervention during follow-up) was 87.5% (28/32). The rates at 3 months, 6 months, and 12 months were 68.8% (22/32), 59.4% (19/32), and 56.2% (18/32). The VAS score decreased from 4.25 ± 1.08 preoperatively to 3.53 ± 1.39 at 1 month postoperatively (p < 0.001), rising to 3.72 ± 1.46 at 12 months postoperatively (p < 0.001). The FBS score decreased from 6.09 ± 1.84 preoperatively to 2.06 ± 1.41 at 1 month postoperatively (p < 0.001), and rebounded to 3.84 ± 2.10 at 12 months postoperatively (p < 0.001). The 12-month efficacy rate remained at 100% for Grade I haemorrhoids, 54.5% for Grade II, 50% for Grade III, and 40% for Grade IV. Minor complications occurred in 9.4% of patients, all resolving without intervention.

Conclusion: HAE demonstrates reliable short-term efficacy for bleeding from Grade I-III internal haemorrhoids. As follow-up duration increases and severity grades rise, symptom relief rates gradually decline. The procedure is safe and reproducible, serving as an alternative minimally invasive option for patients unwilling or unable to undergo excision for Grade I-III internal haemorrhoids. However, patients should be informed of the recurrence risk, and long-term efficacy requires further investigation.