Hemorrhoid (Piles) Embolization
A minimally invasive alternative to hemorrhoid surgery
Understanding Hemorrhoids
Hemorrhoids affect approximately 5% of the population, with prevalence increasing to 50% in adults over 50. They develop when vascular cushions in the anal canal become engorged due to:
- Increased abdominal pressure (chronic constipation, pregnancy)
- Weakening of supporting tissues (aging, genetic predisposition)
- Portal hypertension (in rare cases)
Grade II-IV internal hemorrhoids that persist despite conservative management are prime candidates for embolization therapy.
Hemorrhoid Artery Embolization (HAE)
HAE is an innovative endovascular procedure that reduces blood flow to hemorrhoidal tissue by selectively occluding the terminal branches of the superior rectal arteries. This causes hemorrhoids to shrink while preserving normal rectal circulation through collateral vessels.
Clinical studies demonstrate 85-95% technical success rates with significant symptom improvement in 90% of patients at 1-year follow-up.
Procedure Details
Pre-Procedure Evaluation
- •Complete colorectal examination including anoscopy
- •CT angiography to map hemorrhoidal arteries
- •Bowel preparation with clear liquids day before
- •NPO for 6 hours prior to procedure
Procedure Execution
- •Local anesthesia with conscious sedation
- •1.8mm microcatheter advanced via radial or femoral artery
- •Superselective catheterization of superior rectal artery branches
- •Embolization with 300-500μm microspheres under fluoroscopic guidance
- •Average procedure duration: 60-90 minutes
Post-Procedure Care
- •2-4 hours bed rest with access site monitoring
- •Discharge same day with oral analgesics
- •High-fiber diet and stool softeners recommended
- •Follow-up at 2 weeks and 3 months
Clinical Benefits of HAE
Minimally Invasive
- •No surgical incisions or wound care needed
- •Preserves anal sphincter function
Effective Relief
- •90% reduction in bleeding episodes
- •75-85% improvement in prolapse symptoms
Rapid Recovery
- •Return to work in 2-3 days vs 2-3 weeks with surgery
- •Minimal post-procedural pain
Low Complication Rate
- •No risk of fecal incontinence
- •Significantly lower infection risk than surgery
Potential Risks and Limitations
Procedure-Related Risks
- •
Access Site Complications
Hematoma or pseudoaneurysm (1-3%)
- •
Non-Target Embolization
Rare but possible with improper technique
Therapeutic Limitations
- •
External Hemorrhoids
Less responsive than internal hemorrhoids
- •
Large Prolapses
May require adjunctive procedures
Ideal Candidates for HAE
Inclusion Criteria
- ✓Grade II-IV internal hemorrhoids
- ✓Failed conservative management
- ✓Contraindication to surgery
Exclusion Criteria
- •Active proctitis or anal fissures
- •Coagulopathy or contrast allergy
- •Pregnancy
Long-Term Management
Post-Procedure Care
- •High-fiber diet (25-30g daily)
- •Adequate hydration (2-3L daily)
- •Stool softeners for 2-4 weeks
Monitoring
- •Clinical evaluation at 2 weeks
- •Anoscopy at 3 months
- •Annual follow-up for recurrence