What is Hemorrhoid Artery Embolization (HAE)?

HAE is an effective and minimally invasive treatment for chronic hemorrhoids. An alternative to hemorrhoidectomy and banding surgery, there is no general anesthesia, no hospital stay and no painful recovery. You may return home the same day and resume normal activities.

How is HAE performed?

During the procedure, a specially trained doctor called an interventional radiologist uses imaging to guide a special catheter into the body (through an artery in the wrist or leg) and advances it to the rectal artery. Special coils are inserted into the artery to cut off blood supply to the hemorrhoid, causing it to shrink and symptoms (such as pain and bleeding) to go away.

Who is a good candidate for HAE?

HAE is recommended for those with grade 1 to 3 internal hemorrhoids who have not responded to conservative treatment.

What are the benefits of HAE compared to traditional treatment?

Minimally invasive embolization procedures like HAE are safer for the patient than surgery. It is performed on an outpatient basis, so there is no hospital stay and the associated risk of hospital-acquired infections. There are no incisions or stitching required. There is also no need for general anesthesia, only what is called “twilight” sedation to relax the patient. Hemorrhoid surgery is known for a long and painful recovery, compounded by the fact that the patient must continue to have bowel movements during recovery. With HAE, there is little or no pain at all during the recovery process.

How do I prepare for the HAE procedure?

Your doctor will discuss with you any medications or supplements you may be taking and may ask you to stop taking certain medications (such as blood thinners) prior to the procedure. You will be asked not to eat or drink anything after midnight the night before the procedure. You may need to undergo blood work or diagnostic imaging prior to the procedure.

What should I expect during the HAE procedure?

On the day of your procedure, you are asked to wear loose, comfortable clothing. Arrange to have someone drive you home after the procedure, as the sedation can impair your ability to drive. You will meet with the interventional radiologist, who will explain everything that will happen during the HAE procedure. You will be given twilight sedation. The procedure itself will take about an hour, and will not be painful or uncomfortable. After the procedure, an hour or two of observation will be required, and then you will be able to go home. You will be scheduled for a follow-up visit approximately two weeks after the procedure.

How effective is HAE in treating hemorrhoids?

The success rate of HAE is greater than 90%. Patients do not experience pain or discomfort. Approximately 75% of patients experience no bleeding for at least a year afterward.

Can hemorrhoids recur after HAE?

Yes. Several clinical studies have been performed on the subject. One study found that there was a rebleeding rate of 13.6%. Another study found that the need to perform a repeat embolization procedure was less than 10%. When you talk with Dr. Nazar Golewale, he will share the most current information on hemorrhoid recurrence after HAE with you.

Varicocele Embolization in Chicago and Indiana

Varicocele embolization is a minimally invasive outpatient procedure to treat varicoceles. It is highly effective, requires no hospital stay and the patient can resume normal activities in approximately two days. It is an excellent alternative to open surgery. As varicoceles may return over time, it is safe to repeat this procedure. If you have had surgery in the past, and a varicocele has returned, varicocele embolization may be a good option for you.

The varicocele embolization procedure

Varicocele embolization is performed by an interventional radiologist who inserts a tiny catheter into an artery in the upper thigh or wrist, and then uses fluoroscopic (x-ray) imaging to guide it through the body’s blood vessels to the veins within the testicle. Tiny coils made of stainless steel are inserted into the vein to block the flow of blood, which causes the vein to shrink and eventually disappear. Blood is re-routed by the body through other healthy veins in the testicle.

The procedure is FDA approved and 90% successful—the same as with open surgery. The patient can resume sexual activity 1-2 days after embolization, but it may take 3-6 months for sperm count to improve.

Embolization should only be performed by a trained and experienced interventional radiologist. Complications with this procedure are rare, and can include infection at the catheter insertion site, nausea and mild backache.

Talk to your doctor

Varicocele embolization is an effective and less invasive option to treat varicoceles, performed by Dr. Nazar Golewale of NG Vascular & Vein Ceneter. If you have been diagnosed with a varicocele, talk with your doctor. We are happy to help provide the information you need to make an informed decision. You may also schedule a consultation with one of our doctors by calling our Indiana office at (219) 208-6218 or our Illinois office at (708) 888-1167. We have offices located in Merrillville and Munster, IN, and in Palos Heights and Homewood, IL.