Interventional Treatments for Liver Disease

There are a number of problems in the liver that can be treated with nonsurgical, interventional radiology techniques.

Portal Hypertension Seen most frequently in patients with liver disease such as cirrhosis or hepatitis, portal hypertension is a condition in which the normal flow of blood through the liver is slowed or blocked by scarring or other damage. Patients with the condition are at risk of internal bleeding or other life-threatening complications.

Interventional radiologists treat portal hypertension without surgery, using a procedure called TIPS (transjugular intrahepatic portosystemic shunt). The doctor threads a thin tube (catheter) through a small incision in the skin near the neck and guides it to the blocked blood vessels in the liver. Under X-ray guidance, the doctor creates a tunnel in the liver through which the blocked blood can flow. The tunnel is held open by the insertion of a small metal cylinder, called a stent.

Bile Duct Obstruction In some patients, such as those with liver cancer or individuals who have had an injury to the liver, the bile ducts become blocked and bile cannot drain from the liver. The interventional radiologist places a thin tube (catheter) through the skin and into the bile ducts to drain the bile. In some cases, a small metal cylinder, called a stent, is placed in the liver to hold the blocked area open. A catheter may also be placed to drain bile in patients who have a hole in the bile ducts or as preparation for surgery on the bile ducts.

Chemoembolization is a palliative treatment for liver cancer. This can be a cancer originating in the liver or a cancer that has spread ("metastasized") to the liver from other areas in the body. During Chemoembolization, three chemotherapy drugs are injected directly into the artery that supplies blood to the tumor in the liver. The artery is then blocked off ("embolized") with a mixture of oil and tiny particles.