MINIMALLY INVASIVE TREATMENT
TIPS, DIPS, BRTO & PARTO for Portal Hypertension and Related Conditions
TIPS, DIPS, BRTO, and PARTO are advanced, image-guided interventional procedures used in the management of portal hypertension and its complications, including variceal bleeding, ascites, and selected vascular conditions related to liver disease.
What Are TIPS, DIPS, BRTO & PARTO?
These procedures are specialized interventional radiology techniques designed to manage complications of portal hypertension by modifying abnormal blood flow within the liver and portal venous system.
- TIPS (Transjugular Intrahepatic Portosystemic Shunt) creates a controlled channel within the liver to reduce portal pressure.
- DIPS (Direct Intrahepatic Portosystemic Shunt) is an alternative approach used when standard TIPS is not feasible.
- BRTO (Balloon-Occluded Retrograde Transvenous Obliteration) and
- PARTO (Plug-Assisted Retrograde Transvenous Obliteration) are techniques used to treat gastric or ectopic varices by selectively blocking abnormal veins.
These procedures are performed without open surgery and require detailed imaging and careful patient selection.
When Are These Procedures Considered?
TIPS, DIPS, BRTO, or PARTO may be considered in patients with:
- Portal hypertension due to chronic liver disease
- Variceal bleeding not controlled by medical or endoscopic therapy
- Recurrent ascites or refractory fluid accumulation
- Gastric or ectopic varices
- Budd–Chiari syndrome in selected cases
- Portal vein-related complications of cirrhosis
Suitability is determined after multidisciplinary evaluation, imaging, and liver function assessment.
How These Procedures Are Performed
- Procedures are performed under advanced imaging guidance
- Access is commonly obtained through a neck or venous route
- Specialized catheters and devices are used to create shunts or occlude abnormal veins
- Portal pressures and blood flow are assessed during the procedure
- Each technique is tailored to the patient’s anatomy and clinical condition
Potential Advantages of Image-Guided Portal Interventions
- Minimally invasive alternatives to surgical procedures
- Targeted management of portal hypertension complications
- Can control life-threatening bleeding in selected cases
- Avoids open surgery in patients with advanced liver disease
Recovery and Aftercare
Patients are monitored closely after the procedure, often in a hospital setting. Follow-up imaging, laboratory tests, and clinical evaluations are required to assess response and detect complications.
Recovery recommendations vary based on individual clinical factors and should be followed as advised by the treating medical team.
Risks and Considerations
These advanced procedures carry important risks, including:
- Hepatic encephalopathy
- Bleeding or infection
- Shunt dysfunction or thrombosis
- Liver function deterioration in selected patients
Not all patients experience these effects. Risks depend on liver reserve, underlying disease, and procedural complexity.
Frequently Asked Questions
Are these procedures surgical?
No. TIPS, DIPS, BRTO, and PARTO are minimally invasive, image-guided procedures performed without open surgery.
Are these procedures permanent?
Some procedures create long-term changes in blood flow, while others may require follow-up or additional interventions depending on clinical response.
Do these procedures cure liver disease?
No. These procedures manage complications of liver disease but do not cure the underlying condition.
Consult for Portal Hypertension Management
Detailed clinical evaluation, imaging, and liver assessment are essential to determine whether TIPS, DIPS, BRTO, or PARTO is appropriate