Hemorrhoidal Artery Embolization

 

Hemorrhoidal artery embolization is a minimally invasive procedure that treats bleeding from internal hemorrhoids and provides a safe and effective way to alleviate your symptoms.

 

WHAT ARE HEMORRHOIDS?

Hemorrhoids are blood vessels in the anus or rectum that swell due to increased pressure.This can happen either internally or externally, depending on which blood vessels are affected. Although they may be uncomfortable, hemorrhoids are not generally dangerous.

Internal hemorrhoids

Internal hemorrhoids are composed of a dense artery and vein network located inside the rectum. They are often painless but tend to bleed during bowel movements. They can also prolapse and protrude outside of the anus.

External hemorrhoids

External hemorrhoids are located outside the rectum are more obvious and occur beneath the skin surrounding the anus, forming visible lumps. They can cause pain if irritated or plugged by a blood clot (thrombosed).

Common symptoms of hemorrhoids:

• Bleeding
• Anal itching and skin irritation
• Leakage of stool
• Rectal pain

 

HOW COMMON ARE HEMORRHOIDS?

Hemorrhoids are a frequent problem among both men and women. About ½ of all people will have hemorrhoids by the age of 50 (Peak incidence at 45-65 years of age). Also ~50% of people have a recurrence of symptoms after typical treatments.

 

COMMON CAUSES

• Constipation
• Prolonged sitting
• Diarrhea or straining during bowel movements.
• Obesity
• Sedentary lifestyle or excessive exercise
• Low-fiber diets and certain medications.
• Many women also get hemorrhoids during pregnancy and childbirth

 

TREATMENT

While most hemorrhoids go away on their own with dietary and lifestyle changes, some can persist for longer. This might be due to underlying issues or diseases. Treatments otherwise can range from minimally invasive such as rubber band ligation and infrared photocoagulation to surgery such as hemorrhoidectomy and Doppler guided hemorrhoidal ligation. Alternative non surgical treatments include hemorrhoidal artery embolization (HAE).

 

WHAT IS HEMORRHOIDAL ARTERY EMBOLIZATION?

Hemorrhoidal artery embolization is a minimally invasive outpatient procedure. Embolization is performed with local anesthesia and twilight sedation. During treatment, a small 2-3mm puncture is made in the groin and a catheter is guided to the blood vessels supplying the rectum. Embolization of the hemorrhoidal artery with small coils reduces blood flow and decreases pressure in the veins and improves symptoms. Over time, the hemorrhoids shrink and the bleeding stops.

 

WHEN IS EMBOLIZATION OF HEMORRHOIDS THE RIGHT TREATMENT FOR ME?

HAE is most effective for internal hemorrhoids of grade 1-3 despite lifestyle and dietary changes, or other 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.

 

WHAT ARE THE CONTRAINDICATIONS FOR THE HEMORRHOID EMBOLIZATION?

We may defer embolization for grade 4 internal hemorrhoids and those that require surgery. Embolization is also contraindicated for patients with acute hemorrhoidal complications, a history of colorectal surgery or chronic anal fissures.

 

WHAT ARE THE BENEFITS OF HEMORRHOIDAL ARTERY EMBOLIZATION?

• Minimally invasive, outpatient procedure with no hospital stay
• No general anesthesia needed
• Faster recovery with no incisions or stitches.
• Patients can return to normal activity in 2-3 days.
• No direct anorectal trauma
• Preserves anal continence which avoids stool leakage
• Avoids creation of painful rectal wounds
• Leaves hemorrhoidal tissue in place
• Risks of bleeding or infection are much lower compared to more invasive procedures

 

WHAT ARE THE OUTCOMES WITH HEMORRHOIDAL ARTERY EMBOLIZATION?

In 80-85 percent of cases, symptoms significantly improve after embolization usually within 2-4 weeks. These results last for months after just one treatment, but your results may vary depending on the severity of your condition. If necessary, embolization can be repeated to provide further symptomatic relief.

 

WHAT ARE THE POSSIBLE SIDE EFFECTS OF THIS TREATMENT?

 A few minor complications may occur, including a post-embolization syndrome characterized by a low fever and localized irritation. These symptoms tend to disappear within a few days.

 

IS HAE COVERED BY INSURANCE?

Hemorrhoidal Artery Embolization is covered by most private insurance providers as well as Medicare. We will seek authorization from your insurance company prior to your procedure.