When the liver becomes diseased, most commonly through hepatitis or alcohol disease, the liver cells are progressively replaced by scar tissue. When the condition worsens, there are no longer enough healthy liver cells to perform normal functions. Scarring also leads to a stiffening of the liver and a serious condition called portal hypertension – an increased pressure in the portal veins that drain the intestines. This, in turn, can lead to ascites (an accumulation of fluid in the abdominal cavity) and varices, which can cause recurrent bleeding, mainly at the junction of the esophagus and stomach.
CIRA interventional radiologists perform a highly advanced procedure called transjugular intrahepatic portosystemic shunt (TIPS) to treat portal hypertension by creating new connections between two blood vessels in the liver. Using X-ray guidance, the interventional radiologist guides a catheter through a vein in the neck. On the end of the catheter is a balloon and stent, which are guided into a liver vein. The balloon is then inflated, and the stent is used to connect the portal vein to one of the hepatic veins, easing the pressure on the veins of the stomach, esophagus, intestines and liver, and allowing the blood to flow better. TIPS has an 80-90% success rate and is safer than traditional open surgery.