Early versus rescue transjugular intrahepatic portosystemic shunt in patients with acute variceal bleeding

In patients with liver cirrhosis, acute variceal bleeding has a considerable risk of death. Mortality increases dramatically if bleeding persists or early rebleeding occurs after endoscopic and drug treatments have been applied. This almost fatal situation occurs in 10–20% of patients with variceal bleeding which are now candidates for treatment with the transjugular intrahepatic portosystemic shunt (TIPS) (1,2).