New stent technique could reduce deadly rebleeding in liver cirrhosis

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age 18 to 75 years, regardless of sex. * Diagnosis of liver cirrhosis based on previous histology, imaging, laboratory tests, and/or clinical manifestations. * Hospitalization for acute upper gastrointestinal bleeding, with endoscopic confirmation that the bleeding is related to esophageal varices or type 1 gastroesophageal varices. * Successful control of acute bleeding after standard acute-phase treatment, with stable vital signs and entry into the secondary prophylaxis phase. * Child-Pugh score of 5 to 13. * The investigator judges that both underdilated VCX-TIPS and EVL plus NSBB are clinically feasible and that randomization is appropriate. * The participant or legally authorized representative understands the study procedures and voluntarily signs written informed consent. Exclusion Criteria: * Hemodynamic instability, persistent active bleeding, or need for immediate rescue TIPS, surgical hemostasis, or interventional radiologic hemostasis. * A strong current indication for early or pre-emptive TIPS that makes randomization to EVL plus NSBB clinically inappropriate. * Child-Pugh score greater than 13. * Previous TIPS, surgical portosystemic shunt, BRTO, CARTO, PARTO, or other procedures that substantially alter portosystemic blood flow. * Isolated gastric varices, type 2 gastroesophageal varices, ectopic varices, or a bleeding source other than esophageal varices or type 1 gastroesophageal varices. * Non-cirrhotic portal hypertension. * Cavernous transformation of the portal vein or portal venous thrombosis that makes standardized TIPS technically infeasible. * Previous recurrent or refractory overt hepatic encephalopathy, or a history of West Haven grade II to IV overt hepatic encephalopathy unrelated to gastrointestinal bleeding. * Severe heart failure, severe pulmonary hypertension, severe tricuspid regurgitation, right heart failure, or other contraindications to TIPS. * Uncontrolled severe infection, sepsis, or multiple organ failure. * Hepatocellular carcinoma beyond the Milan criteria or other advanced malignancy. * Severe renal insufficiency requiring long-term renal replacement therapy. * Pregnancy or breastfeeding. * Absolute contraindication to EVL, NSBB, or TIPS. * Any condition that, in the investigator's judgment, makes the participant unsuitable for the study or unable to complete follow-up.