Haemorrhoid Embolisation
Haemorrhoid embolisation is a catheter-based procedure considered for selected patients with bleeding internal haemorrhoids. It aims to reduce arterial blood flow to the haemorrhoidal tissue. It is not a treatment for every type of haemorrhoid or rectal bleeding.
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Assessment comes first
Rectal bleeding should not automatically be attributed to haemorrhoids. An appropriate anorectal examination and, where indicated, investigation of the colon are important. Previous treatments, the degree of prolapse, anaemia and other illnesses influence the decision.
How is the procedure performed?
A thin catheter is introduced through an artery, commonly at the groin or arm. Under imaging guidance, the arteries supplying the haemorrhoidal tissue are reached and embolic materials are used to reduce blood flow. The approach and observation period depend on the individual patient.
Alternatives and limitations
Dietary and bowel habit changes, medicines, rubber band ligation and surgery are among the alternatives. Embolisation is mainly considered for bleeding internal haemorrhoids; thrombosed external haemorrhoids or substantial prolapse may need different treatment. Persistent or recurrent symptoms and additional treatment are possible.
What does the evidence show?
Long-term outcomes and patient selection continue to be studied. NICE guidance recommends this procedure only in a research context because of limitations in the evidence. Expected benefits, uncertainties, risks and alternatives should be discussed before a decision.
Sources
NICE: Superior rectal artery embolisation for haemorrhoids
ASCRS: Management of Haemorrhoids, 2024
Assessment and contact
Suitability and treatment choices are determined individually. Contact Prof. Dr. Ali Fırat at Memorial Ataşehir Hospital.