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A seminal randomized, controlled study in 2010 demonstrated improved survival with the use of preemptive transjugular intrahepatic portosystemic shunt (p-TIPS) in patients with advanced liver disease and acute variceal hemorrhage (AVH). However, the routine use of p-TIPS in these patients has not been achieved in practice. To validate its observed benefits in a real-world setting, researchers examined outcomes of p-TIPS placement in a large multicenter, observational study.
Prospectively enrolled patients had cirrhosis, were admitted with AVH, and had high risk for treatment failure (Child-Pugh class C disease [score <14 points] or class B plus active bleeding at endoscopy). Initial management of AVH was according to current guidelines. Pati…