Hemorrhoid Embolization: Procedure
Embolization is an outpatient non-surgical procedure with minimal downtime. The procedure is done in an outpatient state of the art center where our interventional radiologist performs the fibroid treatment through a tiny tube called a catheter. This procedure can be performed by either placing the catheter in an artery at the top of the leg (called a femoral approach) or by placing it into an artery in the lower arm (called a radial approach).
Embolization can be performed as outpatient with only local anesthesia and does not involve any scopes or direct manipulation of the anorectal region.1,2 Embolization is the process of blocking a blood vessel to prevent blood flow to a part of the body. The reduced blood flow is what treats the hemorrhoids in this procedure.
The blood supply to internal hemorrhoids comes through the superior rectal arteries (SRAs), which branch from a larger blood vessel known as the inferior mesenteric artery.1 A tiny tube is inserted in this artery and a procedure called angiography is performed to visualize all the SRAs.1 Microcatheters (thin, micro-sized catheters) are then introduced in each SRA branch and the abnormal vessels are embolized (blocked) using tiny coils 2-3 mm in diameter.1 This entire process takes one to two hours.1
Hemorrhoid Embolization: Results
Hemorrhoid embolization is technically successful if the doctor can block all the abnormal vessels.1 Notably, doctors are able to achieve a 90-100% technical success rate in the procedure.1,2 This is a good sign for the feasibility of the technique.
The procedure is considered clinically successful if it is able to relieve patient symptoms and improve the quality of life.1 By this definition, the clinical success of the Emborrhoid Technique has ranged from 63% to 94% in various studies.7 Note that the embolizing microcoils may be accompanied by microspheres (tiny spherical particles) to achieve high clinical efficacy of up to 93%.7 However, improved clinical success may come at the cost of a lower rate of minor complications.7
Hemorrhoid Embolization: Recovery
This is an outpatient procedure with minimal downtime. Patients are discharged home usually 1-2 hours after the procedure. Reports estimate a 75% patient satisfaction rate.1 This high rate of satisfaction is understandable, given the short procedure time, absence of any complications, and quick recovery time.1 In fact, patients can return home on the day of the treatment itself.1
Hemorrhoid Embolization: Ideal Candidate
An ideal candidate for embolization is someone that has internal hemorrhoids that has failed other treatments by their gastroenterologist.
Hemorrhoid Embolization: Cost
The procedure is typically covered by most insurance companies. Prior to the procedure you would require a thorough evaluation of your symptoms and medical records by our interventional radiologist to make sure you meet medical necessity for coverage.
Hemorrhoid Embolization: Advantages
Hemorrhoid embolization offers several advantages over other treatment options. There are no surgical risks or alteration of the rectum. The patient’s ability to control anal movements (also known as continence) remains unaffected by the procedure.1 This technique does not create any rectal wounds.1 The anorectal region does not require any local care after the procedure. Most importantly, it is the least invasive surgical technique for hemorrhoid treatment, on par with hemorrhoidal artery ligation.1
Overall, hemorrhoid embolization is a revolutionary new hemorrhoid treatment that is highly successful and feasible for both doctors and patients. Its many advantages set it apart from conventional treatment options. More clinical trials will help to better assess the efficacy of this technique and ultimately take it to the masses.
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- Vidal, V. Hemorrhoid Embolization: Does It Last? Endovascular Today. 2018; 17(4): 82-84.
- Rebonato A, Maiettini D, Patriti A, et al. Hemorrhoids Embolization: State of the Art and Future Directions. Journal of Clinical Medicine. 2021; 10(16): 3537-3544.
- Kibret AA, Oumer M, Moges, AM. Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Plos One. 2021; 16(4): 1-11.
- Nauman K, Samra NS. Anatomy, Abdomen and Pelvis, Anal Triangle. StatPearls. 2020.
- National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of Hemorrhoids. NIDDK. 2016; URL: https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/diagnosis.
- Mott T, Latimer K, Edwards C. Hemorrhoids: diagnosis and treatment options. American Family Physician. 2018; 97(3): 172-179.
- Vidal V, Tradi F. Hemorrhoid artery embolization: Outcome and results – literature review. European Conference on Embolotherapy. 2022; URL: https://www.etconference.org/programme/et-2022-sneak-peeks/haemorrhoid-artery-embolisation-outcome-and-results-literature-review/