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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. It offers significant advantages over traditional methods, providing long-lasting symptom relief with minimal discomfort and a 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. It works by reducing blood flow to the hemorrhoids through the occlusion of the arteries that supply them, thereby alleviating symptoms such as bleeding, pain, and prolapse.

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Procedure Overview

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

  • Under X-ray guidance, a microcatheter is navigated through the arteries to the branches of the superior rectal artery that supply the hemorrhoids.

  • Tiny coils or embolic particles are delivered 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.

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Advantages of HEMBO

Minimally Invasive and Painless

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

Quick Outpatient Procedure

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

Preservation of Anal Anatomy

Hembo™ preserves the anal canal, avoiding complications such as incontinence or stenosis.

High Recovery 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

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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

Comparison before HEMO and after

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
  • Up to 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 factors:
  • The severity of the initial condition
  • Individual patient characteristics
  • Adherence to post-procedure care and lifestyle modifications
HEMBO™ offers several 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 available information, HEMBO™ (HAE) appears to have minimal long-term side effects. Below are the key points regarding the long-term safety and effects 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™, 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 considered a side effect, some patients may require a second embolization if symptoms recur—especially 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, typically resolving 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, thereby reducing the risk of long-term complications associated with more invasive procedures.
1. Grade 2 and 3 hemorrhoids:
  • HEMBO™ is most effective for patients with grade 2 or 3 internal hemorrhoids. The procedure has demonstrated a 95% technical success rate in treating these grades.
2. Grade 4 hemorrhoids:
  • HEMBO™ is generally not recommended for grade 4 hemorrhoids. Patients with advanced hemorrhoids may require more invasive treatments, such as surgical hemorrhoid removal.
3. Overall success rates:
  • A clinical study involving 134 patients showed a 99% success rate in embolizing at least one hemorrhoidal artery.
  • 93% of patients (124 out of 134) reported a positive clinical outcome at the 1-month follow-up.
  • Overall, 80–90% of cases show effective symptom relief following the procedure.
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.
Recovery time following HEMBO (HAE) is generally quick across various grades of hemorrhoids, with several key highlights:
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 there is no specific recovery time defined for each grade of hemorrhoids, recovery is generally quick (2–3 days) for grades 1 to 3, which are the primary candidates for this procedure. The recovery time appears to be similar across these grades, with the main difference being the effectiveness of the treatment rather than the duration of recovery.

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