What is Hemorrhoid Embolization (HAE)?
Hemorrhoid embolization is an interventional radiology treatment for internal hemorrhoids that offers long-lasting relief from rectal bleeding. Hemorrhoids form when abnormal connections are made between arteries and veins in the rectum. Embolization works by blocking these abnormal blood vessel connections, which eliminates the bleeding.
An Interventional Radiologist performs this minimally invasive procedure under local anesthesia and moderate sedation in patients with internal hemorrhoids of grade one, two or three. Internal hemorrhoids are composed of a dense arteriovenous network called Corpus Cavernosum Recti (CCR). The embolization of the hemorrhoidal artery aims to reduce the blood flow in the CCR thus reducing the venous pressure and symptoms.
The procedure is performed through a needle hole in the wrist or the groin through which a thin catheter is inserted into the rectal artery under x-ray guidance. The catheter is guided through the superior rectal artery tree to the terminal branches while the Interventional Radiologist watches the progress of the procedure using moving x-ray (fluoroscope).
Small coils and/or microspheres are placed into the terminal branches of the arteries to seal the vessels. It may be necessary to repeat the embolization for hemorrhoids on the opposite side, through the same opening and using the same catheter and microcatheter combination.
Hemorrhoidal artery coil embolization is a painless technique. The procedure is approximately 45 minutes. After the procedure, patients can return home the same day, and back to work the following day in most situations.
Frequently asked questions
What causes Hemorrhoids?
Hemorrhoids are common and occur in approx. 50% of people during their life with a peak incidence at the age of 45-65 years. They can be caused through an increase in pressure in the lower rectum by the following reasons: straining, sitting for long periods, spinal cord injury, chronic constipation or diarrhea, anal intercourse, family history of hemorrhoids, excessive exercise.
How can I prevent Hemorrhoids?
Eating high fiber food, drinking enough fluid, and exercise can all help with preventing the occurence of hemorrhoids. Avoid straining when sitting on the toilet, and in general, avoid sitting for long periods of time.
When is Embolization of Hemorrhoids the right treatment for me?
The embolization treatment is the best option for you if you suffer from internal hemorrhoids of grade 1, 2 or 3 and treatment despite hygiene and dietary measures, mediation or non-surgical minimally invasive methods were not successful. Also, if you did not benefit from or do not desire a surgical treatment, this technique can be the right option for you. Prior to treatment, imaging may be performed to identify if this procedure is suitable for your vascular anatomy.
What are the contraindications for the Hemorrhoid Embolization technique?
We may not perform this treatment if you have been diagnosed with a grade 4 internal hemorrhoids and should you require surgery, have had acute hemorrhoidial complications, a history of colorectal surgery or chronic anal fissures. Allergy to the contrast medium may require medication to prevent contrast reaction, but it is a not an absolute contraindication.
Do I need to undero any pre-operative imaging prior to Embolization?
We typically do not require preoperative imaging of the arteries as our experience with the procedure is so vast that we can perform this without requiring patients to undergo an additional test or expense.