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Arterial Embolization for the Internal Hemorrhoids Management: A Systematic Review.

Mohammad Hossein Golezar1, Hamed Ghorani1,2, Fakhroddin Alemi1,3

  • 1Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center Tehran University of Medical Sciences Tehran Iran.

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|January 8, 2026
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Summary

Endovascular artery embolization is an effective treatment for symptomatic hemorrhoids, showing good clinical outcomes with minimal complications. This minimally invasive procedure improves quality of life and reduces bleeding in patients with this common anorectal condition.

Keywords:
embolizationemborrhoidhemorrhoidhemorrhoidal arteryrectal artery

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Gastroenterology

Background:

  • Hemorrhoids are the most common benign anorectal condition globally, affecting up to 11% of the population.
  • Symptoms include pain, bleeding, and discomfort, yet hemorrhoids are often underdiagnosed and poorly managed.
  • Endovascular artery embolization presents a novel therapeutic approach for hemorrhoidal management.

Purpose of the Study:

  • To systematically review the efficacy of endovascular artery embolization for hemorrhoids.
  • To evaluate clinical outcomes and morbidity associated with this interventional procedure.
  • To assess the impact of embolization on patient quality of life and symptom recurrence.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase up to August 2022.
  • Included studies underwent rigorous data extraction and quality assessment using the PRISMA 2020 checklist.
  • Two independent reviewers screened studies, excluding reviews, non-English articles, and case reports.

Main Results:

  • Fifteen studies were included, involving patients aged 40.5-72.2 years, with a majority being male (57.89%).
  • Superior rectal artery embolization was performed in 424 patients, primarily using coils or microcoils.
  • No major complications or deaths were reported in most studies; common adverse events included pain, tenesmus, and bleeding. Symptom recurrence requiring re-embolization or surgery occurred in 11.79% of patients.

Conclusions:

  • Rectal artery embolization is a novel and effective treatment for internal hemorrhoids, demonstrating good clinical efficacy.
  • The procedure is associated with minimal significant complications and leads to improved quality of life scores.
  • Embolization effectively reduces bleeding scores, offering a promising alternative for hemorrhoid management.