Hemorrhoids are cushions of vascular tissue that everyone has and that become symptomatic when they engorge, bleed or prolapse. Most respond to fiber, fluid, topical treatment and time. Some do not.
For the ones that do not, the traditional options all involve doing something to the tissue itself — banding, sclerotherapy, stapling or excision. They work, but the anal canal is exquisitely sensitive, and recovery from hemorrhoidectomy is among the more unpleasant experiences in surgery.
Hemorrhoidal artery embolization, sometimes called the emborrhoid technique, attacks the problem from a completely different direction. The engorgement is driven by arterial inflow through the superior rectal arteries. We reach those arteries with a microcatheter and reduce that inflow with coils or particles. The cushions decongest, and the bleeding stops.
Because everything happens inside the blood vessels, nothing is cut, banded or stapled in the anal canal. There is no wound there to heal, which is precisely why patients are able to sit, walk and return to work almost immediately. The technique is particularly well suited to patients whose dominant symptom is bleeding, and to patients on anticoagulation or with medical conditions that make conventional surgery risky.
What the procedure involves
Confirming the source
Rectal bleeding requires a diagnosis before it requires a treatment. We make sure the bleeding has been properly evaluated and that hemorrhoids are genuinely the cause.
Access at the wrist or groin
A needle enters the artery under local anesthesia. A microcatheter is advanced to the superior rectal arteries.
Reducing arterial inflow
Coils and microparticles reduce flow through the arteries feeding the hemorrhoidal cushions, while preserving the collateral supply that keeps the tissue healthy.
Home the same day
The catheter is removed. There is no anal wound, no packing, and no dressing to change.