Your liver is vital to the processing, metabolizing and detoxifying of nutrients and contaminants in the body. Within the liver, a specialized system of blood vessels—the hepatic portal venous system—normally gathers newly digested food and nutrients from the intestines and other organs and brings them to the liver. Liver disease (also called hepatic disease) is a type of damage to or disease of the liver. Any permanent damage and scarring to the liver (cirrhosis) causes backup of the portal venous system and leads to the development of abnormal, fragile, and enlarged veins and possibly portal hypertension.
Cirrhosis, the end-stage of every chronic liver disease, is the major risk factor for the development of liver cancer. Two main types of cancer can affect the liver: Primary liver cancer, which starts in the liver, and secondary liver cancer, which spreads to the liver from another part of the body.
How do IRs treat liver disease?
Interventional radiologists use minimally invasive, image-guided therapies to treat liver diseases like portal hypertension. Bleeding due to portal hypertension may occur in areas such as the esophagus, stomach, small bowel, large bowel and rectum.
To decrease blood flow and pressure in these enlarged veins, an interventional radiologist may place a transjugular intrahepatic portosystemic shunt (TIPS), which shrinks the enlarged veins and returns blood to normal circulation. To do this, the doctor makes a small incision to access the internal jugular vein. Using live X-rays, a catheter is maneuvered through your body’s large veins and into the liver. A small needle is then passed through the liver into the portal venous system. The interventional radiologist then places a stent—a tiny mesh tube—in the liver to direct blood from the portal venous system/veins back into your normal circulatory system.
In treating liver cancer, IRs can deliver targeted treatments to the tumor without medicating or affecting other parts of your body.
- Embolization uses small particles that are injected into the blood vessels leading directly to the tumor. During this treatment, an IR will make a small nick in the area over your hip and use X-ray guidance and a catheter to find these blood vessels supplying the tumor(s). This is generally performed with IV medication for sedation and pain control.
- Ablation destroys liver cancer using extreme temperatures. Using image guidance, while you are under anesthesia, the IR will place special needles through your skin and into your liver tumor. Once the needle is in place, the tumor can be destroyed, often in minutes.
These treatments and/or others might be used alone or together. Your clinical care team, which includes your IR—along with your oncologist, a cancer surgeon and others—will determine which procedure is best for you.
You may be kept in the hospital after the treatment to evaluate the success of therapy, assess your stability after the complex procedure, and monitor for signs of unexpected injury. After treatment for liver cancer, you will follow up routinely with your oncologist and IR. These follow-up appointments might include blood tests and scans.
Disclaimer: SIR is providing this information as a public service. SIR assumes no liability, legal, financial or otherwise for the accuracy of this information or the manner in which it is used. SIR does not offer medical advice. This information is being provided for informational purposes only and should not be used to replace professional medical advice. It is best to seek advice and attention from your physician or qualified health care professional.