Hemorrhoidal Artery Embolization (HAE)

For many patients, hemorrhoids are more than just an occasional annoyance—they’re a painful, persistent condition that affects quality of life. When conservative treatments like topical ointments, diet changes, and rubber band ligation no longer offer relief, many believe surgery is the only option.

But at Prospero Vascular, we offer a less invasive, outpatient alternative: Hemorrhoidal Artery Embolization (HAE).

This innovative procedure targets the blood supply that feeds internal hemorrhoids, providing significant symptom relief without the cutting, sutures, or long recovery associated with surgery. If you’ve been suffering in silence or avoiding traditional hemorrhoid surgery, HAE may be the solution you’ve been waiting for.

What Is Hemorrhoidal Artery Embolization?

Hemorrhoidal Artery Embolization (HAE) is a minimally invasive, image-guided procedure that blocks the abnormal blood flow feeding internal hemorrhoids. By cutting off the vascular supply, the hemorrhoidal tissue shrinks and symptoms such as bleeding, pressure, and pain significantly improve or disappear.

The procedure is performed through a tiny pinhole in the groin or wrist. Using advanced imaging, a catheter is navigated into the arteries supplying the rectum—specifically the superior rectal arteries—and small particles are injected to block blood flow to the hemorrhoids.

There are no incisions, no stitches, and no general anesthesia required. Patients typically return home within a few hours and resume normal activity in a day or two.

Understanding Hemorrhoids

Hemorrhoids are swollen veins located in the lower rectum or anus. While everyone has these vascular cushions, they become problematic when they enlarge, prolapse, or bleed.

There are two main types:

• Internal hemorrhoids: Located inside the rectum. These are often painless but cause bleeding, pressure, or prolapse.
• External hemorrhoids: Found under the skin around the anus. These can become painful, itchy, or thrombosed.

HAE is designed to treat internal hemorrhoids, especially in patients with:

• Persistent rectal bleeding
• Pain or pressure
• Bulging or prolapsing hemorrhoids
• Symptoms that haven’t improved with conservative care
• For external hemorrhoids or thrombosed hemorrhoids, surgical options may still be necessary. However, for internal cases, HAE has emerged as a game-changing non-surgical alternative.

Who Is a Candidate for HAE?

HAE is ideal for patients who:

• Suffer from Grade I–III internal hemorrhoids
• Experience chronic bleeding, discomfort, or prolapse
• Have not responded to conservative treatments (fiber, sitz baths, topical creams, rubber band ligation)
• Want to avoid hemorrhoidectomy or stapled surgery
• Have bleeding disorders or medical conditions that increase the risks of surgery
• Have recurring hemorrhoids after prior surgical treatment
• It is also suitable for elderly patients or those on anticoagulants who cannot undergo traditional surgical hemorrhoid treatment safely.
• HAE is not typically recommended for large external hemorrhoids, acute thrombosis, or patients with advanced prolapse (Grade IV). That said, many patients with combined internal/external symptoms still benefit, especially when bleeding is the primary complaint.

How Does HAE Work?

Hemorrhoids develop due to increased blood flow and pressure in the rectal venous plexus. Over time, this leads to bulging, inflammation, and often bleeding.

HAE interrupts this cycle by blocking the arterial inflow, which reduces pressure in the hemorrhoidal veins. Without a constant blood supply, the hemorrhoids shrink, and symptoms like bleeding, pain, and prolapse improve—without the need for surgical removal.

What to Expect During the Procedure

HAE is performed by an interventional radiologist or vascular specialist in our outpatient suite at Prospero Vascular. The entire process usually takes 60 to 90 minutes, and patients go home the same day.

Step-by-Step Overview

1. Preparation

You’ll receive light sedation and local anesthesia at the access site (usually the groin or wrist).

No general anesthesia is required.

A brief evaluation of your recent imaging or endoscopy reports helps confirm candidacy.

2. Vascular Access

A tiny puncture is made in the femoral artery (groin) or radial artery (wrist).

A thin catheter is navigated through the arteries to the superior rectal arteries, which supply the hemorrhoids.

3. Embolization

A contrast agent is injected to visualize the hemorrhoidal arteries under real-time imaging.

Once confirmed, microparticles are released through the catheter, blocking the abnormal blood flow to the hemorrhoids.

4. Completion and Recovery

The catheter is removed, and the puncture site is sealed.

Most patients rest for 1–2 hours and are discharged the same day.

Recovery is rapid, with minimal post-procedure discomfort.

Benefits of HAE

HAE offers a number of advantages over traditional hemorrhoid surgery:

• Minimally Invasive – No cutting or tissue removal
• Painless Procedure – Performed with local anesthesia and sedation
• Outpatient Setting – Go home the same day
• Quick Recovery – Return to normal activities within 1–2 days
• Does not involve surgical removal of hemorrhoidal tissue; discuss procedure-specific risks with your clinician.
• Repeatable if Necessary – Can be performed again if symptoms return
• Effective for Bleeding Hemorrhoids – Particularly useful for patients with rectal bleeding as the primary issue

Many patients prefer HAE because it avoids the painful recovery and complications that can follow traditional surgical hemorrhoidectomy.

Results and Clinical Outcomes

Studies have shown that HAE offers excellent symptom relief for many patients with internal hemorrhoids.

70% to 90% of patients report major improvements in bleeding and discomfort

Symptom relief can last for years, and repeat embolization is rare

Most patients return to work and daily activity within 24–48 hours

No sutures, no bowel regimen, and minimal post-procedure care required

In one published study, over 80% of patients avoided hemorrhoid surgery entirely after undergoing HAE.

Recovery and Aftercare

After the procedure, most patients:

• Experience minimal soreness at the puncture site
• May notice mild abdominal cramping or bloating for a day
• Resume normal activity in 24 to 48 hours
• See improvement in hemorrhoid symptoms in 1–3 weeks
• Have no dietary or bowel restrictions
• No special wound care, laxatives, or follow-up procedures are needed, and most patients are back to full routine quickly.

Risks and Side Effects

While Hemorrhoidal Artery Embolization is a safe procedure, no treatment is without risks. Potential (but uncommon) complications include:

• Minor bruising or hematoma at the access site
• Temporary abdominal or rectal discomfort
• Non-target embolization (rare with experienced specialists)
• Transient changes in bowel movements
• Infection (extremely rare)

At Prospero Vascular, we follow rigorous protocols to ensure patient safety and comfort throughout the process. The overall complication rate for HAE is very low, particularly in experienced hands.

Who Performs HAE?

At Prospero Vascular, all embolization procedures are performed by a board-certified interventional radiologist or vascular specialist with specific training in non-surgical vascular techniques.

We collaborate with referring gastroenterologists, colorectal surgeons, and primary care providers to ensure the highest quality care and continuity for every patient.

Cost and Insurance Coverage

Hemorrhoidal Artery Embolization is a relatively new treatment in the U.S., but coverage is expanding. Our office will:

• Verify your insurance benefits and coverage before the procedure
• Obtain pre-authorization when needed
• Offer transparent, up-front pricing for patients without insurance coverage
• Provide payment plans for eligible patients

Compared to surgical hemorrhoidectomy, HAE is often more cost-effective, especially when considering time off work and reduced post-op care.

Why Choose Prospero Vascular?

Prospero Vascular is a leader in minimally invasive outpatient procedures, offering advanced vascular and interventional care in a modern, comfortable setting. When you choose us for HAE, you’re getting:

• Expert care from board-certified specialists
• State-of-the-art imaging technology
• Rapid recovery protocols
• Personalized care plans tailored to your needs
• A compassionate team that understands your condition and your goals
• We’re committed to helping patients find relief without surgery, and HAE is one of our most successful and patient-friendly procedures.

Schedule a Consultation

If you’ve been living with painful or persistent internal hemorrhoids and want a real solution that doesn’t involve surgery, Hemorrhoidal Artery Embolization may be the answer.

Contact Prospero Vascular today to learn more, discuss your symptoms, and find out if HAE is right for you.

Call our office or use our online appointment request form to schedule your consultation.

Let’s talk about how HAE can help you move past discomfort and get back to living.

Frequently Asked Questions

Information on this page is educational and does not replace an individual medical evaluation. Please discuss expected benefits, alternatives, and risks with your treating clinician.