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Hemorrhoidal BleedingSTRATOSNCT07559630

Rectal Arterial Embolization vs Band Ligation for the Treatment of Internal hemOrrhoidS

A study testing Hemorrhoidal Artery Embolization and Rubber Band Ligation in people with Hemorrhoidal Bleeding and Hemorrhoids, Internal, run by Jessica K. Stewart, MD at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this clinical trial is to compare two standard of care non-surgical treatments for hemorrhoidal bleeding: hemorrhoidal artery embolization (HAE) versus rubber band ligation (RBL). Read more about this study

Who is it for?
Ages 18 to 89 years
Conditions the study is for
Hemorrhoidal Bleeding, Hemorrhoids, Internal, HAE
What is being tested?
Hemorrhoidal Artery Embolization and Rubber Band Ligation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteUnited States
Study dates
19 May 2026to Nov 2031
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 89 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years and less than 90 years.
  • Ability to provide written informed consent.
  • Documented clinical history of chronic bleeding from internal hemorrhoids.
  • Documented presence of Goligher grade II-III internal hemorrhoids.
  • Failed conservative treatment for bleeding hemorrhoids (e.g. fiber supplementation, topical ointments and creams, dietary modifications, stool softeners, warm baths).
  • Able to comply with all treatments and protocol follow-up visits, in the opinion of the PI's.

Who cannot join

  • Moderate loss of kidney function, defined as estimated glomerular filtration rate of less than 45 mL/min.
  • Significant arterial atherosclerosis that would limit selective angiography.
  • Known alternative causes of GI bleeding.
  • Allergy to iodinated contrast agents.
  • Active infection or malignancy.
  • Pregnancy.
Show all 10Show fewer
  • Active nicotine use within the last 12 months.
  • Portal hypertension/rectal varices.
  • Uncorrectable coagulopathy (INR > 2; Platelet count <100,000; PTT > 40 sec).
  • Findings on baseline CTA that adversely affect treatment, based on PI's clinical judgment, including but not limited to stenosis, occlusion, or hypoplasia of the superior and/or middle rectal arteries.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Aniket Joglekar, MD contact

310-948-8026

ajoglekar@mednet.ucla.edu

Saima Chaabane, PhD contact

424-465-4482

SChaabane@mednet.ucla.edu

United States1 site, 1 recruiting
  • Ronald Reagan UCLA Medical Center

    Los Angeles, California, 90095

    Jessica Stewart, MD, 310-267-8769, JKStewart@mednet.ucla.edu

    Recruiting

Other trials in United States

About this study

Official title: STRATOS: Single-center Randomized Controlled Trial of Rectal Arterial Embolization vs Band Ligation for the Treatment of Internal hemOrrhoidS

The purpose of this clinical trial is to compare two standard of care non-surgical treatments for hemorrhoidal bleeding: hemorrhoidal artery embolization (HAE) versus rubber band ligation (RBL). Directly comparing these two methods may help to clarify which treatment is better for controlling hemorrhoidal bleeding, reducing symptoms, and improving patients' quality of life.

HAE is a standard minimally invasive procedure to put tiny particles or coils into the blood vessel that feeds a hemorrhoid to block the blood flow (embolization). This involves using a catheter inserted into an artery, using twilight (conscious) sedation.

RBL is a standard procedure that involves using small rubber bands around the base of the hemorrhoids to cut off blood flow, causing it to shrink or shrivel.

Read the detailed description

A single center, prospective, open-label, double arm, randomized trial to compare rates of control of bleeding from hemorrhoids, during prospective follow-up in patients with internal hemorrhoids undergoing hemorrhoidal artery embolization (HAE) versus rubber band ligation (RBL), and the number of procedures needed for hemostasis.

Subjects will be considered enrolled in the study once they have provided informed consent. They will then be randomized to one of two arms after completion of the in-person screening visit. Subjects may proceed to the procedure visit after they have met all screening eligibility criteria.

The study will involve a screening period in which patient eligibility is determined. Once eligibility is confirmed, subjects will then be randomized to HAE or RBL in a 1:1 ratio. A total of 40 subjects will be enrolled in the study and followed for a duration of up to 18 months. All study subjects will undergo the initial procedures, consisting of a physical exam, vital signs, medical history, review of medications, laboratory blood evaluations, anascopy, and completion of completion of the hemorrhoidal disease symptom score (HDSS), the short health scale for hemorrhoidal disease (SHSHD), French bleeding score (FBS), and the visual analog scale (VAS) pain score questionnaires.

After treatment follow-up visits will be at 1 week (7 days ± 2 days), 1 month (4 weeks ± 1 week), retreatment (as needed), 2 months (8 weeks ± 2 weeks), 3 months (12 weeks ± 2 weeks), 6 months (24 weeks ± 2 weeks), and 12 months (52 weeks ± 4 weeks) post-procedure. At these visits, subjects will complete all or some of the following: completion of the HDSS, SHSHD, FBS, VAS, and treatment satisfaction questionnaires, review current medications, undergo a directed physical examination, complete laboratory evaluations, anoscopy, CTA abdomen/ pelvis imaging, and report any new adverse events (AEs).

At 6 months, subjects will have the option to crossover because of continued bleeding. Subjects in the crossover group will undergo treatment with the other treatment modality, with follow up at 1 week (7 days ± 2 days), 1 month (4 weeks ± 1 week), retreatment (as needed), 2 months (8 weeks ± 2 weeks), 3 months (12 weeks ± 2 weeks), 6 months (24 weeks ± 2 weeks), and 12 months (52 weeks ± 4 weeks).

Being tested
Hemorrhoidal Artery Embolization, Rubber Band Ligation
Medical subject headings
Hemorrhoids

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hemorrhoidal Artery EmbolizationDevice

    Involves using a catheter inserted into an artery to put tiny particles or coils into the blood vessel that feeds the hemorrhoid to block the blood flow and shrink it.

  • Rubber Band LigationProcedure or surgery

    Involves using a band to cut off blood flow to the hemorrhoid and shrink it.

Study groups in NCT07559630
Study groupRoleWhat they receive
Hemorrhoidal Artery EmbolizationActive comparatorInvolves using a catheter inserted into an artery to put tiny particles or coils into the blood vessel that feeds the hemorrhoid to block the blood flow and shrink it.
Receives: Device: Hemorrhoidal Artery Embolization
Rubber Band LigationActive comparatorInvolves using a band to cut off blood flow to the hemorrhoid and shrink it.
Receives: Procedure: Rubber Band Ligation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of procedures to control bleeding

    To compare rates of control of bleeding from hemorrhoids, based on number of procedures needed for hemostasis, during prospective follow-up in patients with internal hemorrhoids undergoing arterial embolization versus rubber band ligation.

    Measured: 6 months

Secondary outcomes (5)
  1. Complication rates

    Number of complications post procedure for each complication type (such as severe pain, thrombosis, or severe bleeding).

    Measured: 0-18 months

  2. Time to control bleeding

    Number of weeks to control bleeding post procedure

    Measured: 0-18 months

  3. Severe adverse events

    Number of unscheduled ER visits or hospitalization for severe complications.

    Measured: 0-18 months

  4. Patient treatment satisfaction

    Treatment satisfaction questionnaire

    Measured: 0-18 months

  5. Number of crossovers

    Number of subjects who crossover from rubber band ligation to HAE, or vice versa at 6-months post procedure due to continued bleeding.

    Measured: 0-6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Apr 2026
  2. Study start19 May 2026
  3. Primary completionNov 2030 (estimated)
  4. Study completionNov 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
A total of 40 subjects will be enrolled in the double-arm study, subjects will be randomized to HAE or RBL in a 1:1 ratio (20 assigned to HAE, 20 assigned to RBL). Subjects in the either arm will have the option to crossover to the other treatment modality if bleeding is not controlled by their 6-month follow-up time point. Subjects who crossover undergo the other treatment and undergo follow-up visits at \[1 week, 1 month, retreatment (if needed), 2 month, 3 month, 6 month, and 12 months\].
Masking
None (open label)
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07559630
Sponsor's protocol ID
25-2437
Acronym
STRATOS
Status last verified
Jul 2026
First submitted
23 Apr 2026
Last updated
10 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes

Publications

  • Yan Z, Gui Y, Liu C, Zhang X, Wen C, Olatunji OJ, Suttikhana I, Ashaolu TJ. Gastrointestinal digestion of food proteins: Anticancer, antihypertensive, anti-obesity, and immunomodulatory mechanisms of the derived peptides. Food Res Int. 2024 Aug;189:114573. doi: 10.1016/j.foodres.2024.114573. Epub 2024 May 28.

    PubMed 38876600
  • Watanabe N, Hirose M, Hasegawa A, Mochida K, Ogura A, Inoue K. Derivation of embryonic stem cells from wild-derived mouse strains by nuclear transfer using peripheral blood cells. Sci Rep. 2023 Jul 10;13(1):11175. doi: 10.1038/s41598-023-38341-0.

    PubMed 37430017
  • Douek M. Radiofrequency Ablation of Solid, Non-Functional Thyroid Nodules. Tech Vasc Interv Radiol. 2022 Jun;25(2):100821. doi: 10.1016/j.tvir.2022.100821. Epub 2022 Mar 15. No abstract available.

    PubMed 35551805
  • Talaie R, Torkian P, Moghadam AD, Tradi F, Vidal V, Sapoval M, Golzarian J. Hemorrhoid embolization: A review of current evidences. Diagn Interv Imaging. 2022 Jan;103(1):3-11. doi: 10.1016/j.diii.2021.07.001. Epub 2021 Aug 27.

    PubMed 34456172
  • Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012 May 7;18(17):2009-17. doi: 10.3748/wjg.v18.i17.2009.

    PubMed 22563187
  • Panneau J, Mege D, Di Bisceglie M, Duclos J, Habert P, Bartoli A, Vidal V, Tradi F. Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques. Radiographics. 2022 Oct;42(6):1829-1844. doi: 10.1148/rg.220014.

    PubMed 36190848
  • Sandler RS, Peery AF. Rethinking What We Know About Hemorrhoids. Clin Gastroenterol Hepatol. 2019 Jan;17(1):8-15. doi: 10.1016/j.cgh.2018.03.020. Epub 2018 Mar 27.

    PubMed 29601902
  • Jutabha R, Jensen DM, Chavalitdhamrong D. Randomized prospective study of endoscopic rubber band ligation compared with bipolar coagulation for chronically bleeding internal hemorrhoids. Am J Gastroenterol. 2009 Aug;104(8):2057-64. doi: 10.1038/ajg.2009.292. Epub 2009 Jun 9.

    PubMed 19513028

Questions about this trial

What is this clinical trial studying?

A study testing Hemorrhoidal Artery Embolization and Rubber Band Ligation in people with Hemorrhoidal Bleeding and Hemorrhoids, Internal, run by Jessica K. Stewart, MD at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 10 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Aniket Joglekar, MD (310-948-8026, ajoglekar@mednet.ucla.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of procedures to control bleeding (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07559630, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Jul 2026.

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