Interventions of the Hepatic Veins, Inferior Vena Cava, and Portal Vein

Interventional radiology provides an array of minimally invasive procedures, allowing flow modulation in various pathologies involving hepatic veins, portal vein and inferior vena cava (IVC). In a minimally invasive way, transjugular intrahepatic portosystemic shunt (TIPS) is created to manage complications of portal hypertension, such as refractory ascites and recurrent variceal bleeding. Retrograde variceal embolization remains a viable alternative to manage variceal bleeding in patients with cirrhosis, but it does not predispose to hepatic encephalopathy like TIPS. Radiological interventions have changed the treatment paradigm in the management of Budd Chiari syndrome. While endovascular portal vein recanalization ameliorates portal hypertensive complications, such as bleeding and cholangiopathy, portal vein embolization is a deliberate strategy to augment future liver remnant in patients awaiting liver resection. IVC filter placement is an easy but an important measure to prevent pulmonary embolism in patients with deep vein thrombosis. This chapter discusses various intervention radiological procedures involving hepatic veins, portal vein and IVC.