521 - Review of Hemorrhoid Artery Embolization for Symptomatic Internal Hemorrhoids

Monday, April 13, 2026

12:10 PM - 1:10 PM ET

Author/Co-author(s)

SV

Shriya Veluri, BS

MS4
University of Texas Health Science Center at San Antonio: Division of Interventional Radiology, Department of Radiology, United States

Poster Presenter(s)

MA

Muhammad Ayser

Medical Student
UT Health Science Center at San Antonio, United States

Author/Co-author(s)

KH

Kevin Huang, BS

Medical Student
UT Health Science Center at San Antonio, United States
JJ

Jacob Jackson, BS

Medical Student
University of Texas Health Science Center at San Antonio, United States
JY

Jiaming Oliver Yu, BS

MD candidate 2028
Long School of Medicine, United States
Rakesh S. Ahuja, MD

Vascular & Interventional Radiology
Radiology Associates of North Texas, United States

Purpose: Hemorrhoid artery embolization (HAE) has emerged as a promising treatment for symptomatic internal hemorrhoids (IH). Due to the novelty of this procedure, limited data exists on its efficacy and technical details. As such, this review aims to summarize the findings of recent clinical trials that have contributed to our understanding of the role of IR in the treatment of hemorrhoidal disease and provide an update of ongoing trials and future directions.

Materials and Methods: Trial search was conducted using PubMed. Main inclusion criteria included randomized clinical trials and evaluation of the embolic material, technical success, and adverse events of HAE.

Results: A total of three randomized clinical trials were included for review. One trial focused on comparing HAE to surgical hemorrhoidectomy {1} while the other two trials evaluated specific properties of embolic materials (size and embolization agent) {2,3}. In comparison to surgical hemorrhoidectomy, embolization was technically successful in 100% of cases with no severe or life-threatening adverse events. Moreover, postoperative pain levels were significantly lower and bleeding symptoms improved in 83.3% of patients in the embolization group. When comparing various embolization agents, the results suggest that using calibrated microspheres may be more effective and as safe as coil embolization for treating hemorrhoids, while Onyx may be an unsafe embolic agent for this indication due to the risk of ischemic complications. In terms of embolic particle size, Tris-acryl microspheres were safe and effective, with results favoring the use of larger 900-1,200 μm microspheres over smaller sizes to achieve better bleeding control with fewer ischemic complications. An angiographic study was also done to determine anatomic variations of superior rectal arteries to improve the effectiveness of HAE {4}. Four patterns were seen, with 4 main branches (2 left and 2 right) being the most common variation.

Conclusion: Hemorrhoid artery embolization presents as a safe and effective treatment for symptomatic internal hemorrhoids, particularly for those who have not responded to other treatments. While the procedure shows promise, further research is necessary to enhance the understanding of HAE as a treatment option.