Transjugular intrahepatic portosystemic shunts versus balloon-occluded retrograde transvenous obliteration for the management of gastric varices: Treatment algorithm according to clinical manifestations

Transjugular intrahepatic portosystemic shunts (TIPS) are widely used in the management of bleeding gastric varices (GV). More recently, several studies have demonstrated balloon-occluded retrograde transvenous obliteration (BRTO) as an effective treatment method for bleeding isolated GV, especially in patients with contraindications for a TIPS placement. Both TIPS and BRTO can effectively treat bleeding GV with low rebleeding rates. Careful patient selection for TIPS and BRTO procedures is required to best treat the patient's individual clinical situation.