Hemorrhoidal Artery Embolization (HAE)
Hemorrhoidal Artery Embolization (HAE) is a targeted, image-guided procedure that relieves hemorrhoid symptoms by sealing off the arteries responsible for supplying blood to the swollen hemorrhoidal tissue.
What Is Hemorrhoidal Artery Embolization?
Hemorrhoidal Artery Embolization—also known as the emborrhoid technique—is a minimally invasive, image-guided treatment for internal hemorrhoids. Using X-ray guidance, an interventional radiologist threads a catheter through the arteries to reach the superior rectal arteries, which supply blood to the swollen hemorrhoidal tissue. Tiny particles are then released to reduce blood flow, helping the hemorrhoids shrink and relieving symptoms like bleeding, itching, and pain—without any tissue removal.
Who Is the Procedure For?
HAE can be an effective option for patients who have:
- Recurrent rectal bleeding leading to anemia
- Pain, itching, or discomfort during bowel movements
- Grade II–III internal hemorrhoid prolapse
- A medical condition that makes surgery risky, or a personal preference to avoid hemorrhoidectomy
How Is HAE Performed?
The procedure is done in an angiography suite under conscious sedation and local anesthesia. Here’s what to expect:
- Vascular Access
A small incision is made in the wrist (radial artery) or groin (femoral artery), and a thin catheter is introduced into the arterial system. - Navigation
Using fluoroscopy (real-time X-ray), the catheter is navigated into the inferior mesenteric artery and then into the branches of the superior rectal arteries that feed the hemorrhoidal cushions. - Embolization
Contrast dye helps visualize the arterial branches, after which calibrated embolic particles (approximately 100–300 µm in size) are slowly injected until blood flow is sufficiently reduced.
HAE is performed using a catheter to deliver microscopic particles into the arteries feeding the hemorrhoids, reducing blood flow so the tissue shrinks and symptoms are relieved.
Adults with grade II or III internal hemorrhoids who continue to have bleeding, pain, or prolapse after dietary adjustments, topical therapy, or rubber-band ligation may be good candidates for HAE.
Research from international studies indicates that 75–90% of patients achieve meaningful, lasting improvement in bleeding and discomfort within weeks of undergoing the procedure.
HAE is designed to treat internal hemorrhoids. While mild external hemorrhoids may improve as blood flow to the area decreases, larger external hemorrhoids could require additional treatment.
The procedure typically lasts 30–60 minutes, though you should allow several hours for pre-procedure preparation and post-procedure recovery.
Most people can resume work and normal activities within 1–3 days—much sooner than with traditional surgical hemorrhoidectomy.
Temporary pelvic discomfort, a brief urge to pass stool, or a sensation of rectal fullness may occur. Serious issues, such as unintended embolization, infection, or rectal ulceration, are uncommon.
Many insurance providers, including Medicare, cover HAE when other treatments have not been successful. Our billing staff will help verify your coverage.
Bleeding often lessens within the first week, with further improvement over the following 4–6 weeks as the hemorrhoids shrink.
If symptoms return, HAE can often be repeated or used alongside other hemorrhoid treatments for additional relief.
Why Choose HAE?
Hemorrhoidal Artery Embolization offers several advantages:
- Non-surgical approach: No tissue removal and no incisions in the anorectal area
- Minimally invasive: Outpatient procedure with little interruption to daily life
- Symptom relief: Shrinks hemorrhoids and reduces bleeding, discomfort, and itching
- Alternative to surgery: Ideal for patients unresponsive to conservative treatments or reluctant to undergo hemorrhoidectomy
What the Research Says
- HAE has shown high effectiveness, with success rates up to 90% for stopping bleeding and alleviating other symptoms.
- Patients typically notice significant improvement within 2–4 weeks, with many experiencing lasting relief for months.
- Compared to traditional surgery or transanal interventions, HAE often results in lower complication rates, quicker recovery, and minimal discomfort.
After the Procedure
Patients usually go home the same day. Most can return to normal activities within a few days. Discomfort is typically mild and well controlled with over-the-counter pain relief.
Next Steps
If you’re experiencing hemorrhoid symptoms—especially bleeding—that haven’t improved with lifestyle changes or less invasive treatments, HAE might be right for you. Schedule a consultation to learn more, get your questions answered, and determine if this minimally invasive option suits your needs.
TESTIMONIALS
What Our Patients Are Saying
Dr Gonzalez performed prostate pae surgery on me; he explained everything throughly beforehand and I am having wonderful results from same. Dr Gonzalez and his staff are amazing and caring people and I highly recommend.
David M.
Dr. Gonzalez is amazing. He was able to find a rare condition I have that multiple other physicians did not pick up. He is both caring and knowledgeable. He explained all procedures and outcomes clearly and was available for my questions and concerns even after my procedure. He is a five star doctor and I would highly recommend him!
Adrienne V.
Dr. Gonzalez-Beicos and his staff are very professional, knowledgeable, friendly and caring. After dealing for 10 years with BPH, five biopsies, two TURP and three hospitalizations for complications I want to thank Dr. Gonzalez-Beicos and his team. They did and excellent job with a procedure called Prostatic Artery Embolization. I recovered fast and finally I can say that I’m back to normal. I would and do highly recommend him.
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