Pre-emptive transjugular intrahepatic portosystemic shunt (p-TIPS) within 72 hours significantly lowers the risk of death or rebleeding compared to glue obliteration plus non-selective β-blockers (NSBB) in patients with cirrhosis and acute fundal variceal bleeding.
The 1-year probability of survival free from rebleeding was 77% with p-TIPS versus 37% with glue obliteration and NSBB (HR 0.25; 95% CI 0.12–0.51; p<0.0001).
Rates of hepatic encephalopathy and adverse events were comparable between groups, supporting the safety of early p-TIPS in this high-risk population.
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