Editorial: how early should ‘early TIPSS’ be in cirrhosis with acute variceal bleeding?

The concept of early/pre- emptive transjugular intrahepatic portosystemic shunt (TIPSS) was first proposed by Monescillo and col-leagues in a randomised controlled trial (RCT) published in 2004. 1 Its survival benefit in high- risk patients with cirrhosis and acute variceal bleeding (AVB) was shown in a European multi- centre RCT published in 2010