Transjugular liver biopsy is an alternative route for performing biopsies in in patients with deranged blood clotting in whom a percutaneous liver biopsy cannot be performed. It involves puncturing a vein in the neck region and reaching liver by endovascular route. Hepatic vein wedge pressure can also be measured by this technique when required.
It is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension (which is often due to liver cirrhosis) which frequently leads to intestinal bleeding, life-threatening esophageal bleeding (esophageal varices), and the build-up of fluid within the abdomen (refractory ascites). An interventional radiologist creates the shunt using an image-guided endovascular (via the blood vessels) approach, with the jugular vein as the usual entry site.
Radiofrequency ablation, or RFA, is a minimally invasive technique for shrinking tumors, nodules, and other body growths. RFA is used to treat conditions such as benign and malignant tumors, chronic venous insufficiency in the legs, and chronic back and neck pain. RFA can also be used to treat other pain, including stomach pain caused by pancreatic cancer, pelvic pain caused by ovarian cancer, or facial pain caused by trigeminal neuralgia.
Interventional radiologists use balloon-occluded retrograde transvenous obliteration (BRTO) as a minimally invasive technique to treat gastric variceal bleeding. The procedure involves obstructing the dilated vessels, which reduces the risk of rupture. Patients with chronic liver disease often develop abnormal large gastric venous variceal dilatation which may causes significant bleeding. BRTO is a complex procedure which involves embolization of these large gastric venous dilatations via endovascular route in patients who are poorly controlled by endoscopic techniques.
Gastrointestinal endovascular embolization procedures can be performed for arresting bleeding from arteries within the body in the setting of trauma, inflammations, post-surgery, tumoral/ aneurysmal bleeding/pancreatitis, etc. These are lifesaving procedures that involve achieving access to the bleeding vessel through catheters from a small puncture in the groin or wrist artery and embolising or closing these arteries with a wide range of embolic material like coils, gel foam, or particles to arrest the bleeding.
Embolization is a minimally invasive procedure in which materials are used to block the injured vessel and stop the bleeding. A variety of factors, including trauma, blood clotting issues, infections, anatomical problems, and tumors, can result in bleeding that is severe enough to need this treatment.
PTBD & Metallic Stenting
Transhepatic Biliary Percutaneous Drainage (PTBD) A medical procedure called percutaneous transhepatic biliary drainage (PTBD) is used to identify or treat bile duct obstructions. Finding the obstruction or inserting a temporary catheter to empty the bile are the goals of the procedures. PTBD is one of the most essential procedures in cases with dilated IHBR due to failed ERCP stenting, blocked CBD stent, Distal CBD lesion with stenting not possible, and in cases with a non-dilated system with CBD injury. If meticulously performed, this procedure is technically feasible in all cases with a good success rate. It gives immediate symptomatic relief as well as brings down the levels of bilirubin down.