The role of the interventional radiologist. Transjugular procedures.
The transjugular route provides a convenient and safe approach for the interventional radiologist to access the hepatic parenchyma and hepatic vascular structures. The transjugular intrahepatic portosystemic shunt has revolutionized the management of the complications of portal hypertension, allowing the establishment of a side-to-side shunt without recourse to surgery and general anesthesia. On a smaller scale, the transjugular approach to obtaining a liver biopsy has also proven its worth in allowing the histologic diagnosis and staging of liver disease in patients in whom such information is required for appropriate management but major contraindications to percutaneous biopsy exist. This article reviews the current techniques, indications, and complications of these interventional procedures and their role in the management of patients with end-stage liver disease.
Bass
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Liver Transplant Program, Division of Gastroenterology and Liver Transplant Program, University of California, San Francisco, San Francisco, California 94143-0538, USA.
Yao
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D001201:Ascites / Q000601:surgery; D001706:Biopsy / Q000379:methods; D006502:Budd-Chiari Syndrome / Q000601:surgery; D000075202:Contraindications; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000150:complications; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects / Q000379:methods; D011379:Prognosis; D055502:Secondary Prevention