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What is a Vein Bypass?

By Carol Francois
Updated Mar 03, 2024
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Vein bypass sugary is used to redirect the flow of blood in the body from one vein to another. The most common vein bypass surgery is for the portal vein. This vein moves blood from the stomach to the liver. This type of surgery is only performed to release the pressure on the portal vein which is it causing internal bleeding.

The portal vein is a major vein responsible for the regular movement of a high volume of blood. Vein bypass surgery is permanent solution to uncontrolled internal bleeding caused by portal hypertension. Portal hypertension occurs when the liver is unable to absorb the flow of blood from the bowels. The pressure in the vein increases as the body looks for other paths to channel the flow of blood. The most common reasons for liver problems are liver failure and cirrhosis.

In a vein bypass surgery, the vein that directs the blood from the bowels to the liver is detached and reattached to the main venous system. Bypassing the liver allows the body to move the blood without creating excessive pressure on the veins. Portal hypertension and the resulting internal bleeding is found in approximately 40% of cirrhosis patients and ends up being fatal in half. The portal bypass surgery is performed on the surviving patients.

There are four types of vein bypass procedures: portacaval shunting, splenorenal shunting, mesocaval shunting, and transvenous intrahepatic portosystemic shunting (TIPS). All four surgeries are performed under general anesthetic is a hospital. This is major surgery and the risk to the patient is quite high, as they are usually in poor health.

Portacaval shunting diverts the blood from the portal vein into the inferior vena cava. This is the most common method of vein bypass. The inferior vena cava is a main vein that directs the blood towards the heart. In splenorenal shunting, the kidney or renal vein is used to attach the splenic vein. This vein is a part of the larger portal vein and is large enough to accommodate the blood flow.

Mesocaval shunting uses another section of the portal vein, called the superior mesenteric vein to connect with the inferior vena cava. These three methods all require a large incision in the patients’ abdomen and have a lengthy surgical recovery time. Many patients require extensive support after this type of surgery.

The transvenous intrahepatic portosystemic shunt (TIPS) uses specially designed equipment and an x-ray camera to create a shunt using the actual liver. A stent, or artificial vein, is used to link the portal vein to another vein. This procedure requires only a small nick in the skin and has a faster recovery time.

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