What are the techniques available for rescue therapy in variceal bleeding ?
- Balloon tamponade is typically employed if EBL cannot be attempted because of patient instability, or if rebleeding occurs immediately after EBL.
- Transjugular intrahepatic portosystemic shunts (TIPSs) are indicated in the setting of rebleeding after EBL or for initial management of gastric variceal bleeding.
- In experienced centers, early TIPSs for esophageal variceal bleeding has been associated with a decrease in rebleeding and mortality in patients with Child-Pugh class C cirrhosis or class B with active bleeding.
