Portal Hypertension Therapies (TIPS / BRTO)
Treating portal hypertension often means managing the condition and helping to prevent its most dangerous complication: enlarged veins in the stomach lining that can easily burst and cause life-threatening internal bleeding (variceal hemorrhage).
What Is Portal Hypertension?
The main vein leading to the liver is called the portal vein. It is part of the portal venous system, which carries blood from the gastrointestinal (GI) tract and nearby organs to the liver. When blood pressure rises in this vein, it is known as portal hypertension. The most common cause of portal hypertension is cirrhosis (scarring) of the liver.
Signs and symptoms of portal hypertension include:
- Blood in the stool and/or vomiting blood (from a burst vein)
- Abdominal swelling due to fluid accumulation
- Stomach pain
- Swelling (edema) in the legs
- Dilated blood vessels noticeable around the belly button
Gastric Varices, a Dangerous Complication
One of the most common complications of portal hypertension are gastric varices – which are, essentially, varicose veins in the lining of the stomach. These veins are a common cause of GI bleeding. These large, swollen veins can easily burst and lead to life-threatening internal bleeding.
Gastric varices develop when increased pressure in the portal vein causes blood to flow backward, from the liver to the stomach and other areas. This backward flow of blood can lead to the pooling of blood and development of gastric varices. It can also lead to the accumulation of fluid in the abdominal area.
How to Alleviate Portal Hypertension
There are various therapies available for patients with portal hypertension. At Florida Endovascular and Interventional, we offer two remarkably effective methods of preventing dangerous internal bleeding associated with portal hypertension.
In this minimally invasive procedure, a connection is created between two veins, allowing blood flow to bypass a damaged liver. This helps relieve high blood pressure in the liver and prevents complications, such as the development of swollen veins in the stomach as well as their rupture.
During this procedure, our doctors use real-time imaging guidance to dilate the portal vein and insert a stent connecting the portal vein (which carries blood to the liver) to a nearby hepatic vein (which carries blood from the liver back to the heart). This allows some blood to bypass a damaged liver, helping to relieve blood pressure in the portal vein.
A TIPS procedure is performed without any large incisions or the unnecessary cutting of healthy tissue. Rather, our doctors will thread a catheter through the jugular vein at the neck to the hepatic portal vein delivering blood to the liver.
While a TIPS procedure is designed to alleviate pressure in the portal vein by redirecting blood flow, a BRTO procedure is performed when gastric varices (enlarged veins in the stomach lining) already exist.
A BRTO procedure involves blocking blood flow to the enlarged veins, helping to prevent their rupture. There are several ways to block blood flow to the veins, including embolization (creating a blockage in a target blood vessel) and sclerosis (creating a reaction within the target blood vessel that closes it). The method used may vary from patient to patient, depending on the size, number, and location of the enlarged veins – as well as other factors.
BRTO may be used in addition to or in place of a TIPS procedure.
Nonsurgical Relief for High Blood Pressure in the Liver
For patients with advanced liver disease, there are several methods to alleviate portal hypertension and reduce your risk of life-threatening internal bleeding.
At Florida Endovascular and Interventional, our board-certified doctors have the specialized training and experience to perform both TIPS and BRTO procedures. Best of all, these minimally invasive procedures are conducted in our South Florida offices – in Miami Lakes, Plantation, Coconut Creek, and Aventura – for added convenience and comfort.
Call us at (786) 534-2555 to find out more. You can also request your appointment now.