Document type
ArticleVersion
Published versionPublication date
All rights reserved
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/222843
Role of Tips in Acute Variceal Bleeding
Journal Title
Director/Tutor
Journal ISSN
Volume Title
Related resource
Abstract
Purpose of reviewWe aimed to review the role of TIPS in acute variceal bleeding (AVB), focusing on preemptive-TIPS (p-TIPS) as discrepant data suggest room for refinement.Recent findingsSalvage-TIPS can effectively control ongoing AVB despite first-line therapy, but mortality is high. Placing a p-TIPS to prevent failure in high-risk patients may improve survival. This is related to its effect decreasing the overall risk of a further decompensation (FD), not just rebleeding but also ascites and derived complications.SummaryFD is closely related to death risk after AVB. The risk of FD and death concentrates in patients presenting with ascites +/- HE in addition to AVB. p-TIPS improve survival, not only by decreasing rebleeding risk, but mainly FD overall. This review suggests potential improvements to optimize p-TIPS, such as improving risk stratification, restricting the indication to patients with AVB and ascites +/- HE, or selectively identifying those at high-risk of failure (10%-15% cases) for an early placement. Research on these issues is warranted.
Subject
Subject (English)
Citation
Citation
HUERTA, Anna, GARCÍA GUIX, Marta and VILLANUEVA, Càndid. Role of Tips in Acute Variceal Bleeding. Current Hepatology Reports. 2025. Vol. 24, num. 1. ISSN 2195-9595. [consulted: 13 of August of 2026]. Available at: https://hdl.handle.net/2445/222843