Liver Cirrhosis Related Bleeding Management

TIPS For Portal Hypertension In Chronic Liver Disease

Chronic liver disease can gradually increase pressure inside the portal vein, the main vessel that carries blood to the liver. This condition is called portal hypertension. When pressure rises, patients may develop swollen veins in the food pipe or stomach, fluid in the abdomen, or repeated bleeding episodes. These complications can be serious, but modern interventional radiology offers several minimally invasive treatments that help reduce pressure and prevent life-threatening bleeding.
One of the most effective procedures is the TIPS procedure, also known as Transjugular Intrahepatic Portosystemic Shunt. Under image guidance, a small channel is created inside the liver to connect two major veins. A stent is then placed to keep this channel open. This helps blood flow by partially bypassing the liver, reduces portal pressure, and lowers the risk of bleeding from varices. The procedure is performed through a tiny puncture in the neck, without open surgery, and patients usually recover quickly.
In addition to TIPS, specialised procedures like PARTO are helpful for patients who have isolated gastric varices. PARTO, also called Plug-Assisted Retrograde Transvenous Obliteration, works by blocking the enlarged veins from the inside to prevent bleeding. Using a catheter, the doctor reaches the vein from a nearby blood vessel and seals it safely. This method helps stabilize the patient and reduces the chances of future bleeding.
Both TIPS and PARTO are performed under real-time imaging, with minimal discomfort and no large incisions. Most patients are monitored for a short period and are then able to return to daily activities within a few days. These treatments are especially helpful for patients who are not suitable for surgery or those who continue to bleed despite medication and endoscopic therapy.
If you are living with chronic liver disease, experiencing repeated episodes of vomiting blood, abdominal swelling, or unexplained fatigue, it is important to seek timely evaluation by an Interventional Radiologist. Early intervention can prevent complications, improve quality of life, and support long-term liver health. Minimally invasive treatments like TIPS and PARTO offer safe and effective options for managing advanced portal hypertension.

Uterine fibroids are common benign growths in the uterus that can cause a wide range of symptoms — from heavy menstrual bleeding and pelvic pain to bloating and pressure on the bladder or bowel. Many women are told surgery is the only answer, but that’s not always the case. Uterine Fibroid Embolisation (UFE) is a safe, effective, and uterus-preserving option that treats fibroids without the need for hysterectomy or myomectomy.

This procedure is performed through a tiny puncture in the groin or wrist. Using real-time imaging, a thin catheter is guided into the uterine arteries that supply the fibroids. Once in position, small particles are delivered to block blood flow to the fibroids. Without a blood supply, the fibroids gradually shrink, and symptoms begin to improve in the weeks and months that follow.

UFE is ideal for women who wish to avoid major surgery, retain their uterus, or need a faster recovery. It can also be considered for patients who are not suitable for surgery due to medical conditions or personal preferences. Most procedures are done under local anaesthesia with sedation, and patients usually return home the same day or after an overnight stay. Compared to surgical options, UFE involves less pain, fewer complications, and a significantly shorter recovery period.

Patients often report a noticeable improvement in symptoms within the first two to three menstrual cycles. The fibroids continue to shrink over time, and in most cases, the results are long-lasting. UFE does not involve any surgical cuts or stitches, and the uterus remains structurally intact. While fertility after UFE is possible, it is a topic best discussed during consultation, based on individual goals and medical factors.

If you’ve been advised to undergo surgery for fibroids, or are seeking a second opinion, UFE may offer the clarity and comfort you’re looking for. With the right guidance, you can make an informed decision that prioritises both your health and your preferences.

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