Transanal eco-Doppler evaluation after hemorrhoidal artery embolization

Figure 4 Endoanal ultrasound. A-D: Preoperative endoanal ultrasound performed by a linear endocavitary transducer (3DX14L4-9038, BK Medical, Herlev, Denmark). Three-dimensional ultrasound with color Doppler showing grade 3 hemorrhoidal plexus (HP) at 11 o’clock position (A); The mean hemorrhoidal artery (HA) systolic peak velocity was 20.5 cm/s (B); Three-dimensional ultrasound with color Doppler showing grade 3 HP at 1 o’clock position (C); and the mean HA systolic peak velocity was 20.2 cm/s (D); E and F: Endoanal ultrasound at 1-mo follow-up. Three-dimensional ultrasound with color Doppler showing the regression of HP at 11 o’clock position (E); and the reduction of the mean HA systolic peak velocity (8.22 cm/s) (F, same case of Figure A and B). EAS: External anal sphincter; IAS: Internal anal sphincter; PR: Puborectalis muscle.