Cardiovascular and Interventional Radiological Society of Europe

Portal hypertension


Portal hypertension, a major complication of chronic liver disease, refers to abnormally high blood pressure in the portal vein system. The portal vein system transports blood from the stomach, intestines, gallbladder and pancreas to the liver. The most common causes of portal hypertension are liver cirrhosis and blood clots in the surrounding veins.


The main symptoms and complications of portal hypertension include gastrointestinal bleeding, the accumulation of fluids in the abdomen (called ascites), abnormal brain function, infection and kidney failure.


There is no simple test to show if a patient has portal hypertension, so the condition is diagnosed based on the presence of symptoms such as ascites and dilated veins. Common imaging methods for diagnosis include ultrasoundCT, and MRI to evaluate the underlying cause, e.g., liver cirrhosis.


There are a number of treatments available for portal hypertension and the complications resulting from the condition, including endoscopic therapy, surgery and interventional radiology. For example, transjugular intrahepatic portosystemic shunt (TIPS) is an interventional procedure in which an interventional radiologist connects the portal and hepatic veins using a stent (a metal mesh tube). The aim of this procedure is to reduce the pressure in the veins, prevent dilated veins from bleeding and to reduce the formation of ascites. In cases of bleeding, embolization of aberrant and dilated veins can be performed at the same time as a TIPS procedure or as a stand alone intervention.