Evidence map›Paper›PMID 42694533›Full record

ReviewInternational journal of hepatology2026

Pre-Emptive TIPS for Acute Variceal Bleeding: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Wan Muhammad Izhar Bin Wan Ismail, Susmitha Chalamalasetti, Faraz Iqbal, Karan Garg, Aashni Purohit, Hariniska Jayaraman Kannan, Kalyanramnaidu Botsa, Basel Al Khatib, Yaseen Sulaiman, Amar Abdalrazak and 5 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in International journal of hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Wan Muhammad Izhar Bin Wan IsmailDepartment of Gastroenterology, London North West University Healthcare NHS Trust, London, UK.ORCID https://orcid.org/0009-0005-7674-6364
Susmitha ChalamalasettiDepartment of Internal Medicine, St. Francis Medical Center, Monroe, Louisiana, USA.
Faraz IqbalDepartment of Medicine, Hull University Teaching Hospitals, Hull, UK, duhs.edu.pk.ORCID https://orcid.org/0009-0002-1651-4666
Karan GargDepartment of Medicine, Surat Municipal Institute of Medical Education and Research, Surat, India, smimer.suratmunicipal.gov.in.ORCID https://orcid.org/0009-0004-0187-2529
Aashni PurohitDepartment of Medicine, Surat Municipal Institute of Medical Education and Research, Surat, India, smimer.suratmunicipal.gov.in.ORCID https://orcid.org/0009-0003-6689-4342
Hariniska Jayaraman KannanDepartment of Medicine, KAP Viswanatham Government Medical College, Tiruchirappalli, India, duhs.edu.pk.
Kalyanramnaidu BotsaDepartment of Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, India, sriramachandra.edu.in.ORCID https://orcid.org/0009-0001-0524-9011
Basel Al KhatibCollege of Medicine, Alfaisal University, Riyadh, Saudi Arabia, alfaisal.edu.
Yaseen SulaimanDepartment of Surgery, Jordan University Hospital, Amman, Jordan, ju.edu.jo.
Amar AbdalrazakDepartment of Surgery, Jordan University Hospital, Amman, Jordan, ju.edu.jo.
Muhammad SafiullahDepartment of Medicine, King Edward Medical University, Lahore, Pakistan, kemu.edu.pk.ORCID https://orcid.org/0009-0003-7773-2605
Asma'a Munasar Ali AlsubariFaculty of Medicine, Sana'a University, Sana, Yemen, su.edu.ye.ORCID https://orcid.org/0009-0004-8092-7072
Adnan BhatDivision of Hospital Medicine, University of Florida, Gainesville, Florida, USA, ufl.edu.ORCID https://orcid.org/0009-0001-7479-8495
Muhammad Abu ZarDepartment of Internal Medicine, UT Southwestern, Dallas, Texas, USA, utsouthwestern.edu.
Prasun K JalalSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA, bcm.edu.ORCID https://orcid.org/0000-0001-5353-2324

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: There is evolving evidence regarding whether pre-emptive transjugular intrahepatic portosystemic shunt (p-TIPS) improves outcomes in patients with acute variceal bleeding. This meta-analysis is aimed at evaluating the effectiveness of p-TIPS compared with standard care in reducing mortality and rebleeding in high-risk patients with cirrhosis. Methods: We systematically searched CENTRAL, MEDLINE, Embase, and ClinicalTrials.gov to identify randomized controlled trials (RCTs) comparing p-TIPS placed within 72 h of admission with standard care. All statistical analyses were performed using RevMan Version 5.4. Results: Six RCTs ( Conclusions: p-TIPS significantly reduced mortality and rebleeding risk in high-risk patients with acute variceal bleeding, without increasing encephalopathy risk. These findings support its broader integration into clinical practice guidelines. Further large-scale RCTs with extended follow-up are warranted to define optimal patient selection, particularly in gastric variceal subgroups. PROSPERO: CRD420261329675.

Indexed as

acute variceal bleedingliver cirrhosismeta-analysisportal hypertensionpre-emptive TIPSrandomized controlled trials

Identifiers

PMID42694533
PMCPMC13539072

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.