Radiological procedures in portal hypertension.

Area of Science:

• Radiology
• Vascular Surgery
• Gastroenterology

Background:

• Portal hypertension requires accurate radiological diagnosis for effective treatment planning.
• Identifying the precise location of portal obstruction is crucial before surgical or interventional procedures.

Purpose of the Study:

• To discuss various radiological diagnostic methods for portal hypertension.
• To evaluate the advantages, disadvantages, indications, and technical aspects of each method.
• To highlight recent advancements in interventional radiological treatment.

Main Methods:

• Preoperative diagnosis involves direct methods (e.g., splenoportography, transhepatic catheterization) and indirect methods (e.g., celiac artery catheterization).
• Post-shunt procedure assessment utilizes balloon catheters, direct shunt catheterization, or indirect splenoportography.
• Interventional treatment includes percutaneous transhepatic injection of sclerosing agents into the gastric coronary vein.

Main Results:

• Different radiological techniques offer varying degrees of accuracy and invasiveness for diagnosing portal hypertension.
• The choice of method depends on the clinical scenario, including pre- or post-shunt status.
• Percutaneous transhepatic sclerotherapy represents a novel interventional approach for managing portal hypertension.

Conclusions:

• A comprehensive understanding of radiological diagnostic modalities is essential for managing portal hypertension.
• Interventional radiology plays an increasingly important role in both diagnosis and treatment.
• Tailoring the radiological approach to the specific needs of portal hypertension patients optimizes outcomes.