Portal Hypertension: Concepts in Diagnosis and the Role of Transjugular Intrahepatic Portosystemic Shunts in the Management of Complications

Portal hypertension is responsible for many of the manifestations of chronic liver disease. Some of these complications are the direct consequences of portal hypertension, such as gastrointestinal bleeding from either ruptured gastroesophageal varices or portal hypertensive gastropathy, ascites, and portosystemic encephalopathy.In the last 15 years, new endovascular procedures such as transjugular liver biopsy with its hemodynamic evaluation have been playing an important role in the diagnosis and management of this entity. Also, in cases where complications of severe portal hypertension such as acute or refractory bleeding or ascites are present, a transjugular portosystemic shunt procedure can decompress the portal system with a success rate greater than 90% of the cases. This review article provides the basic concepts of portal hypertension and its management using endovascular approach.