Intervention in the Hepatic
Portal Venous System
Christopher Hannegan, MD
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Interventions in the Hepatic Portal System: Diagnostics, Treatments, and Procedures, Summaries of Human Biology
An in-depth analysis of interventions in the hepatic portal system, including diagnostic methods, treatments such as stenting, embolization, and shunts, and procedures like BRTO and islet cell transplantation. It covers anatomy, techniques, and complications.
What you will learn
- What are the indications for intervening in the portal venous system?
- What is the role of BRTO in the treatment of gastric varices?
- What are the diagnostic methods for assessing the portal venous system?
- What are the different treatments for improving flow in the portal venous system?
- What are the complications of interventions in the portal venous system?
Typology: Summaries
2021/2022
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Intervention in the Hepatic
Portal Venous System
Christopher Hannegan, MD
Definition
Portal venous system – Venous vasculature
fed and drained by capillary vessels.
Hypophyseal portal system
Hepatic portal system
Diagnostic methods
- Conventional radiological techniques – U/S, CT,
MR
- Catheter directed techniques
Indirect – Late phase visceral angiography,
wedged hepatic venography
Direct – Transjugular or percutaneous
transhepatic portal access
Anatomy
Computed Tomography
Magnetic Resonance
Wedged hepatic venography
Quick review TIPS
- Decompress symptomatic hypertensive portal system after failed medical management.
- Mainly used to treat bleeding varices and refractory ascites.
- Reduce portal systemic gradient below 12 mmHg to minimize risk of bleeding. Lower for ascites.
- Contraindicated in coagulopathy, biliary obstruction, severe liver disease, encephalopathy and right heart failure.