Treatment
A minimally invasive option for selected patients with bleeding internal hemorrhoids, offered by Buffalo Vascular Care in Western New York.
Buffalo Vascular Care offers hemorrhoid artery embolization (HAE) for selected patients with persistent bleeding from internal hemorrhoids. Our practice is led by Medical Director Dr. Azher Iqbal, a board-certified, fellowship-trained vascular interventional radiologist. Our Depew office is at 6337 Transit Road, Depew, NY 14043, serving the Buffalo area. An evaluation is needed to confirm the source of bleeding and whether HAE is appropriate.
Overview
Hemorrhoid artery embolization, also called hemorrhoid embolization or HAE, is an image-guided procedure that reduces blood flow to bleeding internal hemorrhoids. An interventional radiologist guides a small catheter through an artery in the wrist or groin to the vessels supplying the hemorrhoids. Small coils, particles or both are used to block selected vessels. HAE does not surgically remove hemorrhoidal tissue, but it does require an arterial puncture.
Symptoms
Rectal bleeding should be evaluated rather than assumed to come from hemorrhoids. Other bowel conditions can cause similar symptoms. A clinician can determine whether examination or additional testing is needed. NIDDK: symptoms and causes.
Hemorrhoid types
Internal hemorrhoids develop inside the anal canal and can bleed or protrude outside the anus. HAE is intended primarily to reduce bleeding from internal hemorrhoids. External hemorrhoids occur beneath the skin around the anus and may cause a painful lump, especially when a clot forms. HAE is not a routine treatment for external hemorrhoids. The location and cause of your symptoms help determine the appropriate treatment.
Hemorrhoid Grades
Candidacy
HAE may be considered for selected patients with Grade I, II or III internal hemorrhoids whose main symptom is persistent or recurrent bleeding. Your evaluation considers previous treatments, hemorrhoid grade, other medical conditions and whether a different procedure would better address your symptoms. HAE may be discussed when diet and bowel-habit changes or other treatments have not provided adequate relief.
Candidacy
External hemorrhoids, severe prolapse or Grade IV internal hemorrhoids may require a different approach. HAE reduces arterial blood flow; it does not remove prolapsed tissue. Active infection, bleeding disorders and a severe contrast allergy can affect whether the procedure can be performed safely. A physician must assess these issues individually rather than rely on hemorrhoid grade alone.
What to expect
HAE is not a guaranteed permanent cure. Bleeding can continue or return, and additional treatment may be needed.
Your care team
Dr. Azher Iqbal, Medical Director of Buffalo Vascular Care, is a board-certified, fellowship-trained vascular interventional radiologist. His background includes more than 25 years of experience in image-guided care. This is his broader clinical experience, not an HAE-specific procedure count.
Our team page also describes Dr. Safet Lekperic's expertise in hemorrhoid embolization. Ask which physician will perform your procedure and discuss that physician's HAE experience, proposed approach and follow-up plan. Meet the Buffalo Vascular Care team.
Choosing a doctor
Look for relevant interventional radiology training and a consultation that explains why HAE fits your symptoms. Useful questions include:
Comparison
Treatment depends on bleeding, prolapse, prior care and overall health. These procedures address hemorrhoids differently; no option is appropriate for everyone.
| Consideration | Hemorrhoid artery embolization | Rubber band ligation | Excisional hemorrhoidectomy |
|---|---|---|---|
| How it works | Blocks selected arteries supplying internal hemorrhoids | Places a band around internal hemorrhoidal tissue, which later separates | Surgically removes hemorrhoidal tissue |
| Access | Small arterial puncture in the wrist or groin | Through the anus, without an arterial puncture | Surgical access to remove tissue |
| Clinician | Interventional radiologist | Clinician trained in hemorrhoid banding | Colorectal or general surgeon |
| Usual setting | Outpatient procedure | Office procedure | Surgical facility |
| Anesthesia | Local anesthesia with sedation in BVC's current description | Usually performed without anesthesia; confirm the treatment plan | Anesthesia required; the type depends on the plan |
| When discussed | Selected patients with bleeding internal hemorrhoids | Bleeding or prolapsing internal hemorrhoids suitable for banding | Large external hemorrhoids or significant prolapse that requires tissue removal |
| Recovery discussion | Ask about puncture-site care and activity restrictions | Ask about discomfort, delayed bleeding and possible repeat sessions | Ask about pain management, wound care and activity restrictions |
| Important limitation | Does not remove prolapsed tissue; bleeding may persist or return | May require further treatment | More involved recovery; suitability depends on the individual |
Discuss the trade-offs with your treating physician. This table does not establish that HAE is more effective or has lower recurrence than the alternatives. NIDDK: hemorrhoid treatments.
Outcomes
A 2025 systematic review of 22 studies covering 810 procedures reported technical success of 93% to 100% and clinical success of 63% to 94%. Technical success refers to completing the intended embolization; clinical success concerns symptom improvement. Definitions, techniques and follow-up periods differed across studies, so these ranges are not a single expected success rate. They are published research findings, not Buffalo Vascular Care's own results. Read the systematic review.
Bleeding can return after HAE. In a separate prospective registry of 80 patients, 25 patients reported recurrent bleeding during 12-month follow-up and 17 underwent a second embolization. Individual results depend on patient selection and treatment details. Read the registry study.
Risks
Your physician will discuss the risks of arterial access, contrast material and embolization, as well as the possibility of persistent or recurrent bleeding. Temporary discomfort can occur. Serious complications are possible: a published pilot study reported rectal ischemia, or inadequate blood supply, with bowel injury requiring surgery. That small study does not establish the overall complication rate for HAE. Read the pilot study.
Seek prompt medical care for severe anal pain with rectal bleeding, particularly if accompanied by abdominal pain or fever. After treatment, follow your care team's instructions for concerning symptoms. NIDDK: when to seek care.
Common Questions
Buffalo Vascular Care offers hemorrhoid artery embolization for selected patients with bleeding internal hemorrhoids. The Depew office is at 6337 Transit Road, Depew, NY 14043, in the Buffalo area. Call (716) 852-1977 to discuss an evaluation and confirm the location of your procedure.
HAE is performed by an interventional radiologist. Buffalo Vascular Care is led by Dr. Azher Iqbal, Medical Director, and its team page also lists Dr. Safet Lekperic's HAE expertise. Confirm which physician will perform your procedure during your consultation.
Ask about interventional radiology training, HAE experience, evaluation of the bleeding source and follow-up care. A consultation should explain why HAE is appropriate, how it compares with other treatments and what risks or additional procedures may be involved.
Hemorrhoid artery embolization (HAE) is an image-guided procedure that reduces blood flow to bleeding internal hemorrhoids. A catheter passes through an artery in the wrist or groin to the vessels being treated. HAE does not surgically remove hemorrhoidal tissue.
Yes. An interventional radiologist may treat selected patients with bleeding internal hemorrhoids using HAE. External hemorrhoids and severe prolapse may need a different approach. An evaluation is necessary before recommending treatment.
Published research reports improvement in bleeding for many patients, but outcomes vary. Technical completion of embolization does not guarantee symptom relief. The outcomes section above explains the study findings and their limitations; those findings are not Buffalo Vascular Care's own outcome data.
Buffalo Vascular Care describes using local anesthesia and sedation for HAE. Temporary discomfort can occur, and the experience varies by patient. Your physician will explain pain management and which symptoms require medical attention.
HAE reduces arterial blood flow to internal hemorrhoids. Rubber band ligation places a band around internal hemorrhoidal tissue, which later separates. Excisional hemorrhoidectomy surgically removes tissue. The choice depends on bleeding, prolapse, prior treatments and overall health.
Buffalo Vascular Care's current treatment information describes a procedure time of approximately 1 to 2 hours. Preparation and observation add time to the visit. HAE is generally outpatient, but discharge depends on the care team's assessment.
Some patients notice less bleeding within days to weeks, but improvement is not immediate or guaranteed. Follow-up is needed to assess the response and decide whether further evaluation or treatment is appropriate.
Yes. Bleeding can persist or return after HAE. The care team should reassess the cause before recommending a repeat embolization or a different treatment. HAE should not be described as a guaranteed permanent cure.
Yes. Continue the bowel-care plan recommended by your clinician, including dietary fiber, appropriate hydration and measures to avoid straining or prolonged toilet sitting. Use stool softeners only as advised.
Ask Buffalo Vascular Care about referral requirements and ask your insurer about coverage for the proposed procedure. Coverage and out-of-pocket costs need to be confirmed for your individual plan before treatment.
Buffalo Vascular Care has a Canadian / Self-Pay information page. Contact the practice to discuss HAE eligibility, evaluation requirements, scheduling and an individual estimate. General self-pay information does not confirm that a particular patient's HAE treatment has been approved or priced.
Related treatments
Buffalo Vascular Care also provides information about genicular artery embolization, prostate artery embolization and uterine fibroid embolization. These procedures treat different conditions and require their own evaluations.
Request a consultation to discuss your symptoms and treatment options.
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