Portal Vein Hypertension

The interventional radiology team at UT Southwestern uses state-of- the-art imaging technologies and treatment techniques to relieve portal hypertension, a condition that can cause serious symptoms and lead to dangerous complications.

Specialized Care for Portal Vein Hypertension

Portal vein hypertension is a condition in which an individual’s portal venous system, a major vein that leads to the liver, experiences higher than normal pressure.

The portal vein carries blood from the entire bowel and spleen to the liver. Portal vein hypertension occurs when the blood flow in this vein is obstructed. This condition occurs in patients with chronic liver disease and cirrhosis, wherein the blood flow to the liver is impeded due to a hardened liver. In some patients, portal vein hypertension can occur because of blood clots in the portal vein or veins of the spleen and bowel.

Portal vein hypertension leads to development of multiple dilated veins in the stomach, esophagus, and rectum, which can rupture and cause vomiting of blood or blood in the stool.

UT Southwestern’s team of board-certified interventional radiologists specializes in minimally invasive techniques for treating portal vein hypertension, offering patients fewer risks and shorter recovery times.

In addition to the training that all radiologists receive, our interventional radiologists also have advanced fellowship training in interventional radiology, plus extensive real-world experience.

Our team coordinates the complete cycle of care – from imaging evaluation to post- procedure follow-up – maintaining a high level of communication with the patient throughout the process. In addition, we coordinate closely with experts from across the UT Southwestern community when necessary. 

Treatment for Portal Vein Hypertension

Dilated veins are usually treated with banding or sclerotherapy, a process in which a sclerosing solution, or medicine, is injected into small vessels, causing the vessels to close and slowly fade away.

However, for patients who do not respond to the usual treatment, interventional radiology offers minimally invasive treatments, such as placement of a transjugular intrahepatic portosystemic shunt (TIPS) and variceal embolization.

During TIPS, the portal vein in the liver is directly connected to a liver vein, thus relieving the obstruction to the blood flow in the portal vein. During direct vatical embolization, the dilated veins are cannulated (accessed with a thin tube) and treated by occluding them or by sclerotherapy (injection of an irritant that causes inflammation, coagulation of blood, and narrowing of the blood vessel wall). In patients who have blood clots in the portal vein, bowel veins, or splenic vein, interventional radiology offers special procedures to open these vessels.

Portal vein hypertension can also lead to fluid accumulation in the abdomen, which is usually treated with oral medications. Patients who do not respond to oral medications often require repeated removal of the fluid (also known as paracentesis). TIPS is of great help in reducing the need for repeated paracentesis in such patients.

In patients who are not eligible for TIPS, interventional radiology offers a specialized procedure called peritoneovenous shunt that helps reduce fluid accumulation.