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About HAE

About HEMBO™

HEMBO™ Procedure

A Revolutionary Approach to Treating Hemorrhoids

HEMBO™ (Hemorrhoid Artery Embolization) is emerging as a groundbreaking, minimally invasive treatment for internal hemorrhoids that offers significant advantages over traditional approaches. This innovative procedure provides long-lasting relief from symptoms with minimal discomfort and rapid recovery.

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What is HEMBO? (Hemorrhoid Artery Embolization)

HEMBO™, also known as the “emborrhoid” technique, is a minimally invasive endovascular procedure performed by interventional radiologists to treat internal hemorrhoids. The procedure aims to reduce blood flow to hemorrhoids by occluding the arteries that supply them, thereby alleviating symptoms such as bleeding, pain, and prolapse.

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Procedure Overview

  • A small puncture (2-3mm) is made in the groin or wrist to access the arterial system

  • Using X-ray guidance, a microcatheter is navigated through the arteries to the superior rectal artery branches that feed the hemorrhoids

  • Tiny coils or embolic particles are deployed through the catheter to block blood flow to the hemorrhoidal tissue

  • The procedure typically takes about 45 minutes and is performed under local anesthesia with moderate sedation

Advantages of HEMBO

Minimally Invasive and Painless

HEMBO™ requires no incisions, ensuring minimal pain and quick recovery.

Outpatient Procedure

HEMBO™ is outpatient, with same-day discharge after recovery.

Preservation of Anal Anatomy

HEMBO™ preserves anal canal, avoiding complications like incontinence or stenosis.

High Success Rate

80-85% of patients improve within 2-4 weeks; 90% report no bleeding.

Comparison to Other Treatment Options

Treatment Invasiveness Anesthesia Recovery Time Success Rate Recurrence Risk
HEMBO (HAE)
Minimally invasive
Local + sedation
2-3 days
80-85%
Low
Rubber Band Ligation
Minimally invasive
None/local
1-2 weeks
70-80%
Moderate
Surgical Hemorrhoidectomy
Invasive
General
2-4 weeks
95%
Low
Conservative Management
Non-invasive
None
N/A
Variable
High

Find out if you are a candidate

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Candidacy for HEMBO

HEMBO™ is most effective for internal hemorrhoids of grade 1-3 that have not responded to conservative management or other minimally invasive treatments. It is particularly suitable for patients who wish to avoid surgery or have not benefited from surgical interventions.

Contraindications

HEMBO™ may not be suitable for:

  • Grade 4 internal hemorrhoids

  • Patients with acute hemorrhoidal complications

  • Those with a history of colorectal surgery

  • Patients with chronic anal fissures

Frequently Asked Questions

Success Rates

HEMBO demonstrates high success rates for symptom improvement:
  • 80-85% of patients experience significant symptom improvement within 2-4 weeks after the procedure
  • Over 90% of patients report no further bleeding from their hemorrhoids following embolization
  • As many as 75% of patients report ongoing, significant symptom relief at the 12-month post-procedure follow-up
Current evidence suggests that HEMBO provides lasting relief:
  • Results typically last for several months after a single treatment
  • The procedure has a 95% technical success rate, offering the best results for people with grade 2 or 3 internal hemorrhoids
HEMBO shows favorable outcomes in terms of recurrence and the need for retreatment:
  • Recurrence rates after HAE are relatively low compared to some traditional surgical interventions
  • If necessary, the procedure can be repeated to provide further symptomatic relief
Many patients report high levels of satisfaction with HEMBO due to its minimally invasive nature and effectiveness in symptom relief
The long-term effectiveness of HEMBO may vary depending on several factorst:
  • The severity of the initial condition
  • Individual patient characteristics
  • Adherence to post-procedure care and lifestyle modifications
HEMBO offers some advantages over traditional treatments in terms of long-term relief:
  • Unlike rubber band ligation, which may require multiple sessions and has a higher recurrence rate, HEMBO can provide more lasting relief with a single procedure
  • Compared to surgical hemorrhoidectomy, HEMBO offers comparable results with less morbidity and faster recovery, potentially leading to better long-term outcomes for some patients.
Based on the available information, HEMBO (HAE) appears to have minimal long-term side effects. Here are the key points regarding the long-term effects and safety of this procedure:
  • Low complication rate: HEMBO has demonstrated a favorable safety profile with few reported serious complications. No major or minor complications have been reported based on standard classification systems used in interventional radiology.
  • No anorectal ischemia: There have been no reported cases of anorectal ischemia following HEMBO. This is likely due to the preservation of lower branches feeding the anorectal wall and the presence of anastomoses.
  • Preservation of anal function: HEMBO does not affect anal continence or cause rectal wounds that could lead to stool leakage. The procedure preserves the natural structure of the anal canal.
  • No impact on bowel control: The treatment does not affect a patient’s ability to control bowel movements.
  • Potential need for retreatment: While not a side effect per se, some patients may require a second embolization procedure if symptoms recur, particularly in cases with anatomical variations or high blood supply from middle or inferior rectal arteries.
  • Minimal post-procedure effects: The most common short-term side effects are mild and transient, such as low-grade fever or localized irritation, which typically resolve within a few days.
  • No long-term structural changes: Unlike surgical options, HEMBO does not alter the anatomy of the anal canal or remove hemorrhoidal tissue, potentially reducing the risk of long-term complications associated with more invasive procedures.
1. Grade 2 and 3 hemorrhoids:
  • HEMBO appears to be most effective for patients with grade 2 or 3 internal hemorrhoids. The procedure has a 95% technical success rate for these grades.
2. Grade 4 hemorrhoids:
  • HEMBO is generally not recommended for grade 4 hemorrhoids. Patients with grade 4 hemorrhoids may need to seek more invasive procedures like hemorrhoid removal surgery
3. Overall success rates:
  • A study involving 134 patients showed a 99% success rate in embolizing at least one hemorrhoidal artery.
  • 93% of patients (124 out of 134) experienced a positive clinical outcome during the 1-month follow-up.
  • Approximately 80-90% of cases show effectiveness in providing symptom relief.
4. Long-term results:
  • As many as 75% of patients report ongoing, significant symptom relief at the 12-month post-procedure follow-up.
  • 93% of patients (124 out of 134) experienced a positive clinical outcome during the 1-month follow-up.
  • Approximately 80-90% of cases show effectiveness in providing symptom relief.
5. Repeat procedures:
  • 10 out of 134 patients (about 7.5%) needed repeat embolization in the short term.
  • The procedure can be repeated if necessary, which is an advantage for managing recurrent symptoms.
Based on the search results, the recovery time for HEMBO (HAE) is generally quick across different grades of hemorrhoids, with some key points:
1. Overall recovery:
  • Most patients can return to normal activities within 2-3 days after the procedure.
  • Many patients are able to return to work the day after the procedure.
2. Outpatient procedure:
  • HEMBO is performed as an outpatient procedure, with patients typically going home the same day after a short 2-hour recovery period.
3. Minimal pain and downtime:
  • The procedure causes minimal pain and has a fast recovery compared to more invasive surgical options.
4. Grade-specific information:
  • HEMBO is most effective for grade 1-3 internal hemorrhoids.
  • The search results don’t provide specific recovery times for different grades.
  • For grade 4 hemorrhoids, HEMBO is generally not recommended, and more invasive procedures may be needed.
  • 80-85% of patients experience significant symptom improvement within 2-4 weeks after the procedure.
  • As many as 75% of patients report ongoing, significant symptom relief at the 12-month post-procedure follow-up.
  • If necessary, the procedure can be repeated to provide further symptom relief, which may affect overall recovery time for some patients.
While the search results don’t provide specific recovery times for each grade of hemorrhoids, they suggest that recovery is generally quick (2-3 days) for grades 1-3, which are the primary candidates for this procedure. The recovery time seems to be similar across these grades, with the main difference being the effectiveness of the treatment rather than the recovery period itself.
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