Vascular and Interventional Radiology Treatments for Liver Disease

We provide complete treatment for many liver conditions, such as portal hypertension, cirrhosis and provide liver transplant support.

Biliary tubes and cholecystostomy tubes

The body’s biliary system collects fluid made by the liver called bile. Bile is released into the gastrointestinal (GI) tract through bile ducts to aid in digestion. The gallbladder is a small organ in the biliary system that stores the bile until it is needed.

Gallstones, tumors or scarring and inflammation may block the biliary system or cause an infection. If this happens, an interventional radiologist may use image-guided techniques to place tubes into the bile ducts (biliary tube) or gallbladder (cholecystostomy tube) to aid in bile drainage and/or infection treatment.

Transjugular liver biopsy (TJLB)

If you have diffuse liver disease, liver tissue may be needed to determine treatment. Tissue sampling, or a biopsy, may be done through the hepatic (liver) veins, or through the skin (percutaneous biopsy).

A transjugular liver biopsy is an endovascular procedure where an interventional radiologist uses wires and catheters (thin tubes) to navigate to the hepatic (liver) veins. Here, a small biopsy needle is used to collect a small sample of liver tissue. This procedure is also helpful for gathering other information, such as the pressure in the hepatic vein. Depending on your care needs, a TJLB may be preferred over a percutaneous biopsy.

Transjugular intrahepatic portosystemic shunt (TIPS)

The portal veins carry blood directly from the gastrointestinal (GI) tract to the liver. The liver filters this blood, which is returned to the body’s main circulation through the hepatic (liver) veins.

Blood flow through the liver is limited in advanced stages of liver disease, such as cirrhosis. This may lead to portal hypertension, or high blood pressure in the portal venous system.

Portal hypertension is a serious condition. For some, it leads to enlarged or swollen veins (varices) in the throat and stomach, which can cause life-threatening bleeding. It can also result in ascites, or fluid in the abdomen.

During a TIPS procedure, an interventional radiologist uses image guided endovascular techniques to create a new tract with a stent connecting a hepatic vein to a portal vein. The stent allows blood in the portal vein to bypass the diseased liver. This may help lower portal hypertension.

Balloon-occluded antegrade or retrograde transvenous obliteration (BATO or BRTO)

The portal veins carry blood directly from the gastrointestinal (GI) tract to the liver. The liver filters this blood, which is returned to the body’s main circulation through the hepatic (liver) veins.

Blood flow through the liver is limited in advanced stages of liver disease, such as cirrhosis. This may lead to portal hypertension, or high blood pressure in the portal venous system.

Portal hypertension is a serious condition. For some, it leads to enlarged or swollen veins (varices) in the throat and stomach, which can cause life-threatening bleeding.

A BATO or BRTO is an endovascular procedure. Once an interventional radiologist guides the wires and catheters (thin tubes) to the correct location, they deliver embolic materials or sclerosant directly into the abnormal veins. This closes the abnormal veins and may lower the bleeding risk. In some cases, interventional radiologists perform this procedure along with TIPS.

Portal vein reconstruction

The portal veins carry blood directly from the gastrointestinal (GI) tract to the liver. The liver filters this blood, which is returned to the body’s main circulation through the hepatic (liver) veins.

Blood clots (thrombosis) or tumors may block the portal veins. This decreases the flow of blood and increases blood pressure within the portal veins, known as portal hypertension.

Portal hypertension is a serious condition. For some, it leads to enlarged or swollen veins (varices) in the throat and stomach, which can cause life-threatening bleeding. It can also result in ascites, or fluid in the abdomen.

Portal vein reconstruction is an endovascular procedure, where thrombectomy (blood clot removal) or stent (tube) placement is performed to help keep the portal vein open.

Resources for patients and referring providers

Make an appointment

We require a provider referral to vascular and interventional radiology before scheduling an appointment. Please contact your provider for a referral or visit our website to find a radiologist.

Refer a patient

Referring patients to UW Medicine’s vascular and interventional radiology department is simple.

Common radiology terminology

Common terminology used by our vascular and interventional radiology (VIR) team.