Liver Disease

Mount Sinai Health System is internationally recognized for its comprehensive care for liver disease and liver transplantation. The Division of Interventional Radiology is an integral component in providing exceptional care to patients with a broad spectrum of liver diseases. We strive to improve patient outcomes by offering cutting-edge technology and unparalleled expertise using minimally invasive techniques.

Interventional Radiology Treatments and Procedures

The Division of Interventional Radiology offers many key services for patients with liver disease. These include:

  • Percutaneous Biliary (Bile Duct) Access: Small catheters are inserted through the skin into the bile ducts of the liver. This can be done to treat bile duct stenosis, obstructive jaundice and bile duct stones. Biopsies of the bile ducts and liver can also be performed using this technique.

  • TIPS (Transjugular Intrahepatic Portosystemic Shunt): Using imaging guidance, a small tunnel is made though the liver to connect the portal vein (the vein that carries blood from the digestive organs to the liver) to one of the hepatic veins (three veins that carry blood away from the liver back to the heart). A stent is then placed in this tunnel to keep the pathway open.

  • Patients who typically need a TIPS have portal hypertension which is increased pressure in the portal vein. This pressure causes blood to flow backward from the liver into the veins of the spleen, stomach, lower esophagus, and intestines, causing enlarged vessels, bleeding and the accumulation of fluid in the chest or abdomen.

  • BRTO (Balloon occlusion Retrograde Transvenous Obliteration of gastric varices): First pioneered in Japan in the early 1990s, BRTO stands for Balloon occlusion Retrograde Transvenous Obliteration of gastric varices. In short, patients with portal hypertension and bleeding gastric varices are sometimes candidates for this minimally invasive procedure. A small catheter is inserted into a vein in the leg and advanced into the abnormal veins surrounding the stomach. Using a balloon to prevent damage to normal veins, a sclerosing agent is injected to injure the abnormal bleeding veins.

  • Transjugular Liver Biopsy: A small catheter is inserted into the jugular vein in the neck and advanced into the hepatic vein (large vein that drains blood from the liver) using X-ray guidance. A biopsy of the liver is performed directly from the vein. This is performed in patients who cannot tolerate percutaneous biopsies due to tendency for bleeding or a large amount of fluid in the abdomen.

  • Gastrointestinal Bleeding: A small catheter is inserted in the artery in leg and advanced into the body using imaging guidance to the site of bleeding. Small metallic coils or particles are injected through the catheter to stop the bleeding.