Surgical incision
- HAE
- No
- Traditional Hemorrhoid Surgery
- Yes
Condition
Hemorrhoid Embolization
A minimally invasive, non-surgical treatment for bleeding internal hemorrhoids.
Overview
Through a tiny skin puncture in the wrist or groin, a small catheter is guided to the arteries supplying the hemorrhoids. Using specialized imaging, these vessels are blocked with tiny particles (embolics) and/or metal coils to reduce blood flow to the bleeding or symptomatic internal hemorrhoids. This decreases swelling and bleeding without surgery or tissue removal.
Symptoms
Common symptoms
- Bright red blood during or after bowel movements
- Mucus discharge or staining
- Feeling of fullness or incomplete emptying
- In advanced cases, tissue may prolapse (protrude) outside the anus
Internal vs. External Hemorrhoids
Internal vs. External Hemorrhoids
Internal hemorrhoids develop inside the rectum, most often cause painless bright-red bleeding with bowel movements, and may cause pressure or fullness but usually no visible external lump. These are the primary candidates for our office for Hemorrhoid Embolization (HAE/"Emborrhoid").
External hemorrhoids form under the skin around the anus, causing swelling, itching, and pain (especially if clotted/thrombosed). These are typically treated with creams, lifestyle measures, or office procedures — not embolization. If your main symptom is bleeding from internal hemorrhoids, you may be a candidate for HAE.
Hemorrhoid Grades
Hemorrhoid Grades
- Grade I: Enlarged internal hemorrhoids that do not prolapse outside the anal canal. Bleeding may occur.
- Grade II: Hemorrhoids prolapse during a bowel movement or straining but return inside on their own.
- Grade III: Hemorrhoids prolapse during bowel movements or straining and must be manually pushed back inside.
- Grade IV: Hemorrhoids are permanently prolapsed and cannot be manually reduced.
Who Is a Candidate?
Who Is a Candidate?
You may be a good candidate if you have:
- Grade I, II or III internal hemorrhoids with persistent bleeding
- Symptoms not improved with diet, creams, banding, or other procedures
- A preference to avoid invasive surgery or if you are not a good surgical candidate
- Recurrent symptoms after 3 to 6 months of optimized medical therapy
Who Is Not a Candidate?
Who Is Not a Candidate?
- Grade IV hemorrhoids or severe prolapse that usually require surgical removal
- Active infection, uncontrolled bleeding disorders, or severe contrast allergy that cannot be safely managed
Benefits of HAE at Buffalo Vascular Care
Benefits of HAE at Buffalo Vascular Care
- No incisions or stitches — only a pinhole skin puncture
- No general anesthesia — performed with local anesthesia and comfort sedation
- Same-day discharge — outpatient procedure
- Rapid recovery and quick return to normal activities
- Reduced recurrence rates compared with some traditional methods
- Procedure performed in the comfort of our centrally located, office-based interventional suite
Comparison
HAE vs. Hemorrhoid Surgery
| HAE | Traditional Hemorrhoid Surgery | |
|---|---|---|
| Surgical incision | No | Yes |
| Hemorrhoids surgically removed | No | May be |
| Treatment approach | Artery embolization | Surgical |
| Performed by | Interventional Radiologist | Surgeon |
| Setting | Outpatient | Varies |
| Recovery | Generally shorter | Typically longer |
| Appropriate for everyone | No | No |
Hemorrhoids surgically removed
- HAE
- No
- Traditional Hemorrhoid Surgery
- May be
Treatment approach
- HAE
- Artery embolization
- Traditional Hemorrhoid Surgery
- Surgical
Performed by
- HAE
- Interventional Radiologist
- Traditional Hemorrhoid Surgery
- Surgeon
Setting
- HAE
- Outpatient
- Traditional Hemorrhoid Surgery
- Varies
Recovery
- HAE
- Generally shorter
- Traditional Hemorrhoid Surgery
- Typically longer
Appropriate for everyone
- HAE
- No
- Traditional Hemorrhoid Surgery
- No
Common Questions
Frequently Asked Questions
What is hemorrhoid artery embolization?
Hemorrhoid Artery Embolization (HAE) is a minimally invasive, image-guided treatment for symptomatic internal hemorrhoids, particularly hemorrhoids that cause persistent or recurrent bleeding. During the procedure, a small catheter is guided into the arteries supplying the hemorrhoids. These arteries are then embolized to reduce blood flow to the hemorrhoidal tissue, helping improve bleeding and other related symptoms. HAE does not require surgical removal of the hemorrhoids.
Who performs hemorrhoid artery embolization?
HAE is performed by an interventional radiologist, a physician specially trained to perform minimally invasive treatments using advanced imaging and catheter-based techniques.
Can an interventional radiologist treat hemorrhoids?
Yes. Interventional radiologists can treat certain types of hemorrhoids without traditional hemorrhoid surgery. Using a procedure called hemorrhoid artery embolization, the physician treats the arteries supplying the hemorrhoids from inside the blood vessels. An evaluation is necessary to determine whether HAE is appropriate for your particular symptoms and type of hemorrhoids.
Can hemorrhoids be treated without surgery?
Yes. Not all hemorrhoids require surgery. Conservative treatments such as increased dietary fiber, hydration, stool softeners, topical medications, and changes in bowel habits may improve symptoms. Office-based procedures such as rubber-band ligation may also be appropriate. For selected patients with symptomatic internal hemorrhoids, hemorrhoid artery embolization offers a minimally invasive treatment option without surgically cutting or removing the hemorrhoids.
What are alternatives to hemorrhoid surgery?
Depending on the type and severity of hemorrhoids, alternatives may include dietary and lifestyle changes, medications, rubber-band ligation, sclerotherapy, infrared coagulation, and hemorrhoid artery embolization (HAE). The most appropriate treatment depends on your symptoms, hemorrhoid grade, previous treatments, and overall health.
Will it hurt?
Most patients feel little to no pain. We use local anesthesia and sedation to keep you comfortable.
Is HAE painful?
HAE is generally associated with less post-procedure pain than traditional surgical hemorrhoid removal because the hemorrhoidal tissue is not surgically cut or removed. Patients may experience temporary discomfort or other mild symptoms following treatment. Your physician will discuss what to expect and how to manage any symptoms.
How long does it take?
Usually 1–2 hours. You go home the same day.
When will I see results?
Many patients notice reduced bleeding within days to weeks, with continued improvement over time.
Is this permanent?
Relief is long-lasting for many, though results vary. If bleeding returns due to collateral arteries, a targeted re-embolization may help.
Do I still need lifestyle measures?
Yes. Even after HAE, it's important to:
- Maintain a high-fiber diet (fruits, vegetables, whole grains)
- Drink plenty of water
- Use stool softeners if recommended by your provider
- Avoid excess straining or prolonged sitting on the toilet
- Stay physically active to support bowel health
Talk to Dr. Azher Iqbal about Hemorrhoid Embolization
Request a consultation to discuss your symptoms and treatment options.
Most insurance accepted